Efficacy and Safety of Rechallenge with BRAF/MEK Inhibitors in Advanced Melanoma Patients: A Systematic Review and Meta-Analysis

被引:11
|
作者
Priantti, Jonathan N. [1 ]
Vilbert, Maysa [2 ,3 ]
Madeira, Thiago [4 ]
Moraes, Francisco Cezar A. [5 ]
Hein, Erica C. Koch [2 ,3 ,6 ]
Saeed, Anwaar [7 ]
Cavalcante, Ludimila [8 ]
机构
[1] Fed Univ Amazonas UFAM, Sch Med, BR-69020160 Manaus, AM, Brazil
[2] Univ Hlth Network, Princess Margaret Canc Ctr, Toronto, ON M5G 2M9, Canada
[3] Univ Toronto, Dept Med, Div Med Oncol, Toronto, ON M5S 1A8, Canada
[4] Fed Univ Minas Gerais UFMG, Sch Med, BR-30130100 Belo Horizonte, MG, Brazil
[5] Fed Univ Para UFPA, Sch Med, BR-66075110 Belem, PA, Brazil
[6] Pontificia Univ Catolica Chile, Sch Med, Dept Hematol & Oncol, Santiago 8331150, Chile
[7] Univ Pittsburgh, UPMC Hillman Canc Ctr, Dept Med, Div Hematol & Oncol, Pittsburgh, PA 15213 USA
[8] Novant Hlth Canc Inst, Dept Med Oncol, Charlotte, NC 28204 USA
关键词
advanced melanoma; targeted therapy; rechallenge; BRAF; MEK inhibitors; MAPK inhibitors; RANDOMIZED PHASE-III; ADVANCED BRAF(V600)-MUTANT MELANOMA; TRAMETINIB COMBINATION THERAPY; ADVANCED METASTATIC MELANOMA; DABRAFENIB PLUS TRAMETINIB; QUALITY-OF-LIFE; CUTANEOUS MELANOMA; MALIGNANT-MELANOMA; OPEN-LABEL; TARGETED THERAPY;
D O I
10.3390/cancers15153754
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Simple Summary Approximately 50% of patients with melanoma harbor a BRAF mutation and are eligible for targeted therapy with BRAF/MEK inhibitors (BRAFi/MEKi). Despite a response rate of nearly 70%, more than half of the patients will experience disease progression within a year due to tumor resistance. Rechallenging patients with BRAFi/MEKi has emerged as an alternative for improving response and survival outcomes. This systematic review and meta-analysis aims to investigate the efficacy and safety of this strategy in patients with advanced melanoma. This systematic review and meta-analysis aims to evaluate the efficacy and safety of rechallenging advanced melanoma patients with BRAFi/MEKi. Seven studies, accounting for 400 patients, were included. Most patients received immunotherapy before the rechallenge, and 79% underwent rechallenge with the combination of BRAFi/MEKi. We found a median progression-free survival of 5 months and overall survival of 9.8 months. The one-year survival rate was 42.63%. Regarding response, ORR was 34% and DCR 65%. There were no new or unexpected safety concerns. Rechallenge with BRAFi/MEKi can improve outcomes in advanced melanoma patients with refractory disease. These findings have significant implications for clinical practice, particularly in the setting of progressive disease in later lines and limited treatment options.
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页数:16
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