Tuesday, April 10, 2018
BRAF/MEK for melanoma brain tumors? Yep! It works!
Brain mets suck great big green hairy wizard balls. Period. Now, this....
Clinical and radiological response of BRAF inhibition and MEK inhibition in patients with brain metastases from BRAF-mutated melanoma. Geukes, Boogerd, Blank, et al. Melanoma Res. 2018 Jan 19.
Patients with brain metastases (BM) from melanoma have an overall survival (OS) of 2-6 months after whole-brain radiotherapy. Targeted therapy (TT) is an effective treatment for BRAF-mutated metastatic melanoma. Moreover, recent studies indicate intracranial responses of TT in patients with BM. We analyzed 146 patients with BM from BRAF-mutated melanoma treated with vemurafenib, dabrafenib, or dabrafenib+trametinib between 2010 and 2016. We determined clinical and radiological response, progression-free survival (PFS), and OS. Median OS of patients treated with dabrafenib+trametinib was 11.2 months (n=30), 8.8 months for dabrafenib alone (n=31), and 5.7 months for vemurafenib (n=85). A significantly longer OS was observed in the dabrafenib+trametinib group than in the vemurafenib group. Median intracranial PFS of all patients was 4.1 months. Median intracranial PFS for patients treated with dabrafenib+trametinib was 5.8 months, 5.7 months for dabrafenib, and 3.6 months for vemurafenib. A total of 63 (43%) patients had symptomatic BM. Intracranial disease control rate at 8 weeks in these patients was 65 versus 70% extracranially. Neurological symptoms improved in 46% of patients with symptomatic BM, whereas in 21%, they remained stable. Median OS in patients with BM from BRAF-mutated melanoma treated with dabrafenib+trametinib was significantly longer than for vemurafenib. Improvement of neurological symptoms was seen in almost half of the patients with symptomatic BM treated with TT.
Okay, so most of this is a no-brainer!!! The BRAF/MEK combo does better than BRAF inhibitors alone - in brain or body! We have known this for how long???? BUT, it does confirm (again) that targeted therapy...the BRAF/MEK combo for melanoma peeps whose tumors are BRAF positive...works in the brain and the body!
For what it's worth. - c