Abstract 4117
Background
Metastatic melanoma remains a disease with poor prognosis even in patients with BRAF mutation, treated by BRAF/MEK inhibitors. In many countries immune checkpoints inhibitors which could be used for 2nd line treatment are not registered, or not reimbursed. At the same time, experimantal evidence supports enhancing the effectiveness of chemotherapy after blocking the MAP-kinase pathway. We evaluated the immediate effectiveness of chemotherapy in patients after progression or intolerance on BRAF/MEK inhibitors
Methods
We conducted a retrospective analysis of all patients (pts) who received paclitaxel 175 mg / m2 day1 + carboplatin AUC = 5 day 1 (PC) from January 1 2012 to Mar 30 2016 (n = 55). Group 1 (n = 26) was treated with BRAF / MEK inhibitors (vemurafenib, dabrafenib, trametinib, encorafenib or binimetinib) before PC, group 2 (n = 29) received no inhibitors of BRAF / MEK prior to PC
Results
Both groups did not differ in demographic characteristics (mean age 52.5 ± 12,4 years in group 1 and 53.7 ± 11,6 years respectively, p = 0.5, males 46.1% and 58.6% respectively, p = 0.78), the primary tumor origin (Unknown 15% and 17.2% respectively, skin 85% and 81.8% respectively p> 0.5), or the tumor stage at the start of chemo (III unresectable 7.6% and 0%, IV M1a 11.5% and 13.6%, IV M1b 15.4% and 18.2%, IV M1c 65.3% and 68.2%, respectively, p > 0.5). BRAF mutations rate was higher in Group 1 (96,2% vs 24,1%, p 0.05). Best overall response rate was calculated (Table 1). The median time to progression in Group 1 was 16 weeks (95% CI 6.12 to 23.87 months) and 7.0 weeks (95% CI 5.17 to 8,28) in Group 2; p = 0.019, HR = 2,14 (95% CI 1.08 to 4.21). The median overall survival can not be calculated correctly due to short follow-up (median 28 weeks).
Best overall response rate
Group 1, n (%) | Group 2, n (%) | p value | |
---|---|---|---|
CR | 1 (4) | 0 (0) | >0.05 |
PR | 10 (38) | 1 (3.4) | >0.05 |
OR | 11 (42) | 1 (3.4) | >0.05 |
SD | 5 (19) | 3 (10.3) | ConclusionsMAP-kinase pathway inhibition could enhance effetivenes of subsequent chemotherapy with PC. To evaluate the clinical significance of this observation further studies are needed. Clinical trial identificationLegal entity responsible for the studyIgor Samoylenko FundingN N Blokhin Russian Cancer Research Center DisclosureI.V. Samoylenko: Consultant at BMS, MSD, Novartis. G. Kharkevich, L.V. Demidov: Consultant at Roche, MSD, BMS, Novartis. Resources from the same session2354 - The clinicopathologic features and treatment of 607 hindgut neuroendocrine tumor (NET) patients at a single institutionPresenter: Seung Tae Kim Session: Poster Display Resources: Abstract 2594 - Neuroendocrine carcinomas of the colorectal origin - Polish experiencePresenter: Agnieszka Kolasińska-Ćwikła Session: Poster Display Resources: Abstract 2539 - Neuroendocrine neoplasms of the appendix including goblet cell carcinoidsPresenter: Agnieszka Kolasinska-Cwikla Session: Poster Display Resources: Abstract 1245 - Prognostic validity of AJCC staging system in neuroendocrine tumors of the appendixPresenter: Amir Mehrvarz Sarshekeh Session: Poster Display Resources: Abstract 3902 - Enhancer of zest homolog 2 (EZH2) expression in well and moderately differentiated pancreatic neuroendocrine tumor (pNET)Presenter: Riccardo Marconcini Session: Poster Display Resources: Abstract 3882 - Differential clinical and pathological characteristics of hereditary neuroendocrine pancreatic tumours (NEPT)Presenter: Gema Marín Zafra Session: Poster Display Resources: Abstract 2296 - Natural course of thyroid cancer nodules compared with benign thyroid nodulesPresenter: Kyung-Jin Yun Session: Poster Display Resources: Abstract 4083 - Reassessment of proliferative activity at disease progression in neuroendocrine neoplasmsPresenter: Noemi Cicchese Session: Poster Display Resources: Abstract 3866 - 18F-FDG-PET to predict disease progression in advanced digestive neuroendocrine neoplasmsPresenter: Maria Rinzivillo Session: Poster Display Resources: Abstract 3651 - UK phase IV, observational study to assess quality of life in patients (pts) with pancreatic neuroendocrine tumours (pNETS) receiving treatment with everolimus: The “real-world” OBLIQUE studyPresenter: John Ramage Session: Poster Display Resources: Abstract This site uses cookies. Some of these cookies are essential, while others help us improve your experience by providing insights into how the site is being used. For more detailed information on the cookies we use, please check our Privacy Policy.
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