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Titel: Discontinuation of BRAF/MEK-Directed Targeted Therapy after Complete Remission of Metastatic Melanoma—A Retrospective Multicenter ADOReg Study
VerfasserIn: Stege, Henner
Haist, Maximilian
Schultheis, Michael
Fleischer, Maria Isabel
Mohr, Peter
Meier, Friedegund
Schadendorf, Dirk
Ugurel, Selma
Livingstone, Elisabeth
Zimmer, Lisa
Herbst, Rudolf
Pföhler, Claudia
Kähler, Katharina
Weichenthal, Michael
Terheyden, Patrick
Nashan, Dorothée
Debus, Dirk
Kaatz, Martin
Ziller, Fabian
Haferkamp, Sebastian
Forschner, Andrea
Leiter, Ulrike
Kreuter, Alexander
Ulrich, Jens
Kleemann, Johannes
Bradfisch, Fabienne
Grabbe, Stephan
Loquai, Carmen
Sprache: Englisch
Titel: Cancers
Bandnummer: 13
Heft: 10
Verlag/Plattform: MDPI
Erscheinungsjahr: 2021
Freie Schlagwörter: targeted therapy
complete response
advanced melanoma
discontinuation
disease progression
second-line immunotherapy
DDC-Sachgruppe: 610 Medizin, Gesundheit
Dokumenttyp: Journalartikel / Zeitschriftenartikel
Abstract: The advent of BRAF/MEK inhibitors (BRAFi/MEKi) has significantly improved progressionfree (PFS) and overall survival (OS) for patients with advanced BRAF-V600-mutant melanoma. Long-term survivors have been identified particularly among patients with a complete response (CR) to BRAF/MEK-directed targeted therapy (TT). However, it remains unclear which patients who achieved a CR maintain a durable response and whether treatment cessation might be a safe option in these patients. Therefore, this study investigated the impact of treatment cessation on the clinical course of patients with a CR upon BRAF/MEK-directed-TT. We retrospectively selected patients with BRAF-V600-mutant advanced non-resectable melanoma who had been treated with BRAFi ± MEKi therapy and achieved a CR upon treatment out of the multicentric skin cancer registry ADOReg. Data on baseline patient characteristics, duration of TT, treatment cessation, tumor progression (TP) and response to second-line treatments were collected and analyzed. Of 461 patients who received BRAF/MEK-directed TT 37 achieved a CR. TP after initial CR was observed in 22 patients (60%) mainly affecting patients who discontinued TT (n = 22/26), whereas all patients with ongoing TT (n = 11) maintained their CR. Accordingly, patients who discontinued TT had a higher risk of TP compared to patients with ongoing treatment (p < 0.001). However, our data also show that patients who received TT for more than 16 months and who discontinued TT for other reasons than TP or toxicity did not have a shorter PFS compared to patients with ongoing treatment. Response rates to second-line treatment being initiated in 21 patients, varied between 27% for immune-checkpoint inhibitors (ICI) and 60% for BRAFi/MEKi rechallenge. In summary, we identified a considerable number of patients who achieved a CR upon BRAF/MEK-directed TT in this contemporary realworld cohort of patients with BRAF-V600-mutant melanoma. Sustained PFS was not restricted to ongoing TT but was also found in patients who discontinued TT.
DOI der Erstveröffentlichung: 10.3390/cancers13102312
Link zu diesem Datensatz: urn:nbn:de:bsz:291--ds-341058
hdl:20.500.11880/31362
http://dx.doi.org/10.22028/D291-34105
ISSN: 2072-6694
Datum des Eintrags: 26-Mai-2021
Bezeichnung des in Beziehung stehenden Objekts: Supplementary Materials
In Beziehung stehendes Objekt: https://www.mdpi.com/article/10.3390/cancers13102312/s1
Fakultät: M - Medizinische Fakultät
Fachrichtung: M - Dermatologie
Professur: M - Keiner Professur zugeordnet
Sammlung:SciDok - Der Wissenschaftsserver der Universität des Saarlandes

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