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Poster display session: Basic science, Endocrine tumours, Gastrointestinal tumours - colorectal & non-colorectal, Head and neck cancer (excluding thyroid), Melanoma and other skin tumours, Neuroendocrine tumours, Thyroid cancer, Tumour biology & pathology

3226 - The analysis of treatment sequencing and clinical outcomes in BRAF-positive and BRAF-negative unresectable/metastatic melanoma patients treated with systemic therapies in routine practice.

Date

21 Oct 2018

Session

Poster display session: Basic science, Endocrine tumours, Gastrointestinal tumours - colorectal & non-colorectal, Head and neck cancer (excluding thyroid), Melanoma and other skin tumours, Neuroendocrine tumours, Thyroid cancer, Tumour biology & pathology

Topics

Cytotoxic Therapy;  Targeted Therapy

Tumour Site

Melanoma

Presenters

Anna Czarnecka

Citation

Annals of Oncology (2018) 29 (suppl_8): viii442-viii466. 10.1093/annonc/mdy289

Authors

A.M. Czarnecka, P. Teterycz, I. Lugowska, P. Rogala, T. Switaj, P.L. Rutkowski

Author affiliations

  • Department Of Soft Tissue/bone Sarcoma And Melanoma, Maria Sklodowska-Curie Institute - Oncology Center, 02-781 - Warsaw/PL

Resources

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Abstract 3226

Background

BRAF V600 mutation was considered as a negative prognostic factor in metastatic (stage IV) melanoma patients (pts). Nowadays, two effective systemic treatment modalities - targeted therapy with BRAF+MEK inhibitors and immunotherapy are available for this group of pts contrary to BRAF-wild-type patients where only immunotherapy is used. It is unclear what is the outcome of therapy and treatment sequence in advanced melanoma patients with BRAF-positive and negative patients in the routine practice.

Methods

In this retrospective one-center study, we included 276 (134, 48.6% BRAF V600 mutated) consecutive pts with unresectable/metastatic stage III/IV melanoma treated between 01/2016 and 02/2018. Kaplan-Meier survival probability estimation and Cox’s proportional hazards model were used for analysis.

Results

The first line treatment comprised of anti-PD1 antibodies (in 167 cases, i.e. all BRAF-negative and 25 BRAF-mutant pts) and BRAF/MEK inhibitors (in 109 cases BRAF+ pts). The 1-year overall survival (OS) rates were 61.6% (95% confidence interval, CI: 53.4-71.1) in BRAF-negative pts, 61.1% (95%CI: 51.8-72.1) and 77.3% (95%CI: 61.6-97.1) in BRAF-mutated pts who started BRAF/MEK inhibitors or anty-PD1 antibodies as the first line treatment, respectively. In the multivariable model adjusted for age, sex and LDH level BRAF-mutated pts who received anti-PD1 as 1st line treatment had slightly worse first line progression-free survival (HR: 1.91, 95%CI: 1.00-3.63, p = 0.05), but there were no differences in the multivariable model for OS (HR: 0.67, 95%CI: 0.28-1.58, p = 0.35).

Conclusions

The short-term outcomes of advanced melanoma patients treated with modern systemic therapies are similar independently of BRAF V600 mutation status. Numerically, the best survival rates were reached in BRAF-positive pts who received anti-PD1 antibodies as the 1st line treatment, but this effect needs to be confirmed in a larger population study.

Clinical trial identification

Legal entity responsible for the study

Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology in Warsaw, Poland.

Funding

Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology in Warsaw, Poland.

Editorial Acknowledgement

Disclosure

A.M. Czarnecka: Honoraria, Speakers’ bureau, Travel expenses reimbursement: Bristol-Myers Squibb, Roche, Novartis, Merck, Pfizer, GlaxoSmithKline. P. Teterycz: Honoraria, Travel expenses reimbursement: Roche, Eli Lilly, Bayer, Novartis. I. Lugowska, P. Rogala, T. Switaj: Honoraria, Speakers' bureau, Travel expenses reimbursement: Bristol-Myers Squibb, Roche, Novartis, Merck, Pfizer, GlaxoSmithKline. P.L. Rutkowski: Honoraria: Bristol-Myers Squibb, Roche, Novartis, Merck, Sharp & Dohme, GlaxoSmithKline; Paid consulting role with Bristol-Myers Squibb, Roche, Merck, Sharp & Dohme, Blueprint Medicines, Amgen; Speakers’ bureau: Novartis, Pfizer, Merck, Sharp & Dohme; Institutional research funding: Bristol-Myers Squibb, Novartis; Travel expenses reimbursement: Novartis,Orphan Drugs.

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