Carlino Matteo S, Vanella Vito, Girgis Christina, Giannarelli Diana, Guminski Alex, Festino Lucia, Kefford Richard F, Menzies Alexander M, Long Georgina V, Ascierto Paolo A
Melanoma Institute Australia and The University of Sydney, Sydney, New South Wales, Australia.
Crown Princess Mary Cancer Centre Westmead, Sydney, New South Wales, Australia.
Br J Cancer. 2016 Nov 22;115(11):1280-1284. doi: 10.1038/bjc.2016.321. Epub 2016 Oct 6.
It is unknown whether melanoma patients achieving complete response (CR) with targeted therapy can safely discontinue treatment.
All patients treated with BRAF/MEK inhibitors achieving CR and ceasing treatment before progression were identified. Clinical data at treatment initiation, cessation and progression were examined.
A total of 12 eligible patients were identified, with median follow-up of 16 months, of whom 6 (50%) recurred at a median of 6.6 months after treatment cessation. One patient lost to follow-up until presentation with symptomatic recurrence was the only relapser to die. At relapse, the remaining five patients had an LDH <1.2 times ULN, four were ECOG 0 and one ECOG 1. Baseline characteristics and time to CR and to discontinuation did not influence the rate of relapse.
A large proportion of patients achieving CR with BRAF/MEK inhibitors relapse after treatment cessation. The optimal treatment duration in such patients is unclear, particularly where alternative treatments are available.
采用靶向治疗实现完全缓解（CR）的黑色素瘤患者能否安全地停止治疗尚不清楚。
确定所有接受BRAF/MEK抑制剂治疗且在疾病进展前实现CR并停止治疗的患者。检查治疗开始、停止和进展时的临床数据。
共确定了12例符合条件的患者，中位随访时间为16个月，其中6例（50%）在停止治疗后中位6.6个月复发。1例失访，直至出现症状性复发，是唯一复发死亡的患者。复发时，其余5例患者的乳酸脱氢酶（LDH）<正常上限（ULN）的1.2倍，4例东部肿瘤协作组（ECOG）体能状态评分为0，1例为1。基线特征、达到CR的时间和停止治疗的时间均未影响复发率。
很大一部分采用BRAF/MEK抑制剂实现CR的患者在停止治疗后复发。此类患者的最佳治疗持续时间尚不清楚，尤其是在有其他治疗方法可用的情况下。
