Real-world use and outcomes of targeted therapy and immunotherapy for adjuvant treatment of BRAF -mutated melanoma patients in the United States.

IF 1.5 4区 医学 Q3 DERMATOLOGY
Melanoma Research Pub Date : 2024-10-01 Epub Date: 2024-07-16 DOI:10.1097/CMR.0000000000000990
Sanjay Chandrasekaran, You-Li Ling, Jackson Tang
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引用次数: 0

Abstract

Using a customized, harmonized US electronic health record database, real-world prescription patterns of first-line adjuvant immunotherapy and targeted therapy were retrospectively assessed for BRAF V600-mutated melanoma. Adults with BRAF V600 mutation-positive stage IIIA-D cutaneous melanoma who received first-line adjuvant immunotherapy (nivolumab or pembrolizumab) or targeted therapy (dabrafenib plus trametinib) between 1 January 2014 and 30 August 2020 in the NOBLE database were included. Patients were followed from first-line adjuvant therapy initiation for at least 6 months, until death, progression, follow-up loss, or data cutoff. Primary endpoints were proportion of patients receiving either therapy in first-line and second-line, treatment switching, treatment timing, and status at the end of first-line therapy. Secondary endpoints included discontinuation rates, recurrence-free survival (RFS), and overall survival (OS). Of 318 patients evaluated, 67.6% received nivolumab, 14.2% pembrolizumab, and 18.2% targeted therapy as first-line adjuvant therapy. Median treatment duration was longest for nivolumab (292 days) and shortest for targeted therapy (115 days). Reason for discontinuation was recorded for 195 of 274 patients who discontinued first-line therapy; most common reasons were treatment completion and treatment-related toxicity [87/158 (55.0%) and 29/158 (18.4%), respectively, in immunotherapy-treated patients; 9/37 (24.3%) and 21/37 (56.8%) in targeted therapy-treated patients]. Median RFS and OS for targeted therapy and nivolumab were not reached and were 34.6 and 38.1 months, respectively, for pembrolizumab. These results inform on prescription preferences and clinical outcomes for BRAF V600-mutated melanoma patients in the first-line adjuvant setting.

美国用于 BRAF 突变黑色素瘤患者辅助治疗的靶向疗法和免疫疗法的实际使用情况和疗效。
利用定制、统一的美国电子病历数据库,对BRAFV600突变黑色素瘤一线辅助免疫疗法和靶向疗法的实际处方模式进行了回顾性评估。NOBLE数据库纳入了2014年1月1日至2020年8月30日期间接受一线辅助免疫疗法(nivolumab或pembrolizumab)或靶向疗法(达拉非尼加曲美替尼)的BRAFV600突变阳性IIIA-D期皮肤黑色素瘤成人患者。从一线辅助治疗开始,对患者进行至少 6 个月的随访,直至死亡、病情进展、随访丧失或数据截止。主要终点是接受一线和二线任一疗法的患者比例、治疗转换、治疗时机和一线治疗结束时的状态。次要终点包括停药率、无复发生存率(RFS)和总生存率(OS)。在接受评估的318名患者中,67.6%接受了nivolumab治疗,14.2%接受了pembrolizumab治疗,18.2%接受了靶向治疗作为一线辅助治疗。nivolumab的中位治疗时间最长(292天),靶向治疗最短(115天)。在274例停止一线治疗的患者中,195例记录了停止治疗的原因;最常见的原因是治疗结束和治疗相关毒性[免疫治疗患者分别为87/158(55.0%)和29/158(18.4%);靶向治疗患者分别为9/37(24.3%)和21/37(56.8%)]。靶向治疗和 nivolumab 的中位 RFS 和 OS 均未达到,而 pembrolizumab 的中位 RFS 和 OS 分别为 34.6 个月和 38.1 个月。这些结果为一线辅助治疗BRAFV600突变黑色素瘤患者的处方偏好和临床结果提供了参考。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Melanoma Research
Melanoma Research 医学-皮肤病学
CiteScore
3.40
自引率
4.50%
发文量
139
审稿时长
6-12 weeks
期刊介绍: ​​​​​​Melanoma Research is a well established international forum for the dissemination of new findings relating to melanoma. The aim of the Journal is to promote the level of informational exchange between those engaged in the field. Melanoma Research aims to encourage an informed and balanced view of experimental and clinical research and extend and stimulate communication and exchange of knowledge between investigators with differing areas of expertise. This will foster the development of translational research. The reporting of new clinical results and the effect and toxicity of new therapeutic agents and immunotherapy will be given emphasis by rapid publication of Short Communications. ​Thus, Melanoma Research seeks to present a coherent and up-to-date account of all aspects of investigations pertinent to melanoma. Consequently the scope of the Journal is broad, embracing the entire range of studies from fundamental and applied research in such subject areas as genetics, molecular biology, biochemistry, cell biology, photobiology, pathology, immunology, and advances in clinical oncology influencing the prevention, diagnosis and treatment of melanoma.
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