Queirolo Paola, Spagnolo Francesco
Department of Medical Oncology, IRCCS San Martino - IST Istituto Nazionale per la Ricerca sul Cancro, Largo R. Benzi, 10, 16132, Genoa, Italy.
Cancer Metastasis Rev. 2017 Mar;36(1):35-42. doi: 10.1007/s10555-017-9660-6.
BRAF plus MEK-targeted drugs have out-performed BRAF inhibitor monotherapy in three randomized phase 3 studies, and such combinations have become a new standard of treatment for BRAF-mutant advanced melanoma. With an overall response rate of about 70%, no other therapy in melanoma has shown a better response rate in late-phase clinical trials than combined BRAF and MEK inhibitors; the rapid kinetics of response make them the ideal front-line treatment for symptomatic, BRAF-mutant advanced melanoma patients. Nevertheless, the development of mechanisms of resistance limits the duration of response to such treatment in the majority of cases, with only about 20% of patients treated with the combination being progression-free at 3 years. The aim of this review is to report the efficacy and safety outcomes of the combination of BRAF plus MEK inhibitors compared with BRAF inhibitor monotherapy and immunotherapy, as well as to discuss future perspectives to improve outcomes based on current clinical and translational research studies.
在三项随机3期研究中,BRAF联合MEK靶向药物的疗效优于BRAF抑制剂单药治疗,这种联合用药已成为BRAF突变型晚期黑色素瘤的新治疗标准。总体缓解率约为70%,在晚期临床试验中,黑色素瘤的其他治疗方法均未显示出比BRAF和MEK抑制剂联合治疗更好的缓解率;快速的反应动力学使其成为有症状的BRAF突变型晚期黑色素瘤患者的理想一线治疗方案。然而,耐药机制的出现限制了大多数患者接受此类治疗的缓解持续时间,接受联合治疗的患者中只有约20%在3年时无疾病进展。本综述的目的是报告BRAF联合MEK抑制剂与BRAF抑制剂单药治疗及免疫治疗相比的疗效和安全性结果,并基于当前的临床和转化研究探讨改善治疗结果的未来前景。