37P - First-line BRAF/MEK-inhibitors versus anti-PD-1 monotherapy in BRAFV600-mutant advanced melanoma patients: A propensity-matched survival analysis

Background

Anti-PD-1 antibodies and BRAF/MEK inhibitors are the two main groups of systemic therapy in the treatment of BRAF^V600-mutant advanced melanoma. Until now, data is inconclusive on which therapy to use as first-line treatment. The aim of this study was to use propensity score matching to compare first-line anti-PD-1 monotherapy vs. BRAF/MEK inhibitors in advanced BRAF^V600-mutant melanoma patients.

Methods

We selected patients diagnosed between 2014-2017 with unresectable III or stage IV melanoma and a known BRAF^V600-mutation treated with first-line BRAF/MEK inhibitors or anti-PD-1 antibodies, registered in the Dutch Melanoma Treatment Registry. Patients were matched based on their propensity scores using the nearest neighbour and the optimal matching method.

Results

Between 2014-2017, a total of 330 and 254 unresectable stage III or IV melanoma patients received BRAF/MEK inhibitors and anti-PD-1 monotherapy as first-line systemic therapy. In the matched cohort, consisting of 310 patients, patients receiving anti-PD-1 antibodies as a first-line treatment had a higher median and twelve-month overall survival compared to patients treated with first-line BRAF/MEK inhibitors, 42.3 months (95%CI: 37.3-NE) vs. 19.8 months (95%CI: 16.7-24.3) and 83.0% (95%CI: 77.3-89.2) vs. 65.3% (95%CI: 58.2-73.3).

Conclusions

Our data suggest that in the matched BRAF^V600-mutant advanced melanoma patients, anti-PD-1 monotherapy is the preferred first-line treatment in patients with relatively favourable patient and tumour characteristics. Results from currently ongoing randomised clinical trials are awaited to confirm these results.

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

J.B.A.G. Haanen: Advisory/Consultancy: Amgen; Advisory/Consultancy: AstraZeneca; Advisory/Consultancy: Bayer; Advisory/Consultancy, Research grant/Funding (institution): BMS; Advisory/Consultancy: Celsius Therapeutics; Advisory/Consultancy: GSK; Advisory/Consultancy: Immunocore; Advisory/Consultancy: Ipsen; Advisory/Consultancy, Research grant/Funding (institution): MSD; Advisory/Consultancy: Merck Serono; Advisory/Consultancy, Research grant/Funding (institution): Novartis; Advisory/Consultancy, Research grant/Funding (institution): Neon Therapeutics; Advisory/Consultancy: Pfizer; Advisory/Consultancy: Roche/Genentech; Advisory/Consultancy: Sanofi; Advisory/Consultancy: Seattle Genetics. C.U. Blank: Research grant/Funding (institution): Novartis; Advisory/Consultancy, Research grant/Funding (self): BMS; Research grant/Funding (institution): Nanostring; Advisory/Consultancy: MSD; Advisory/Consultancy: Roche; Advisory/Consultancy: Novartis; Advisory/Consultancy: GSK; Advisory/Consultancy: AstraZeneca; Advisory/Consultancy: Pfizer; Advisory/Consultancy: Lilly; Advisory/Consultancy: GenMab; Advisory/Consultancy: Pierre Fabre; Shareholder/Stockholder/Stock options: Uniti Cars; Shareholder/Stockholder/Stock options: Neon Therapeutics; Shareholder/Stockholder/Stock options: Forty Seven. M. Aarts: Honoraria (self): BMS; Honoraria (self): Pierre Fabre; Honoraria (self): Servier; Honoraria (self): MSD; Honoraria (self): Novartis. J.W. de Groot: Advisory/Consultancy: BMS; Advisory/Consultancy: Pierre Fabre; Advisory/Consultancy: Servier; Advisory/Consultancy: MSD; Advisory/Consultancy: Novartis. G.A. Hospers: Advisory/Consultancy: Amgen; Advisory/Consultancy, Research grant/Funding (institution): BMS; Advisory/Consultancy: Roche; Advisory/Consultancy: MSD; Advisory/Consultancy: Pfizer; Advisory/Consultancy: Novartis; Research grant/Funding (institution): Seerave. E. Kapiteijn: Advisory/Consultancy: Amgen; Advisory/Consultancy, Research grant/Funding (self): BMS; Advisory/Consultancy: Novartis; Advisory/Consultancy: Merck; Advisory/Consultancy: Pierre Fabre. K. Suijkerbuijk: Advisory/Consultancy: BMS; Advisory/Consultancy: MSD; Honoraria (self): Novartis; Honoraria (self): Pierre Fabre; Honoraria (self): Roche. A.A.M. Van der Veldt: Advisory/Consultancy: BMS; Advisory/Consultancy: MSD; Advisory/Consultancy: Roche; Advisory/Consultancy: Novartis; Advisory/Consultancy: Pierre Fabre; Advisory/Consultancy: Pfizer; Advisory/Consultancy: Sanofi; Advisory/Consultancy: Ipsen; Advisory/Consultancy: Eisai. M. Boers-Sonderen: Advisory/Consultancy: Pierre Fabre; Advisory/Consultancy: MSD; Advisory/Consultancy: Novartis. A.J.M. van den Eertwegh: Advisory/Consultancy: BMS; Advisory/Consultancy, Research grant/Funding (institution): Roche; Advisory/Consultancy: MSD; Advisory/Consultancy: Novartis. All other authors have declared no conflicts of interest.