Hematology & Oncology (Cancer), University of Chicago Comprehensive Cancer Center, Chicago, IL 60637, USA.
Novartis Pharmaceuticals Corporation, East Hanover, NJ 07936, USA.
Future Oncol. 2019 Sep 1;15(25):2933-2942. doi: 10.2217/fon-2018-0964. Epub 2019 Feb 25.
Targeted therapy (TT) and immuno-oncology (IO) drugs are approved for patients with BRAF mutant metastatic melanoma (MM). We compared real-world outcomes for first-line (1L) TT versus 1L IO to evaluate optimal sequencing. Physicians-identified BRAF mutant MM patients initiating 1L TT or IO therapies and extracted treatment, disease and clinical outcomes including disease response which were compared between TT and IO and individual regimens. 440 MM patients (TT = 283, IO = 157) were identified. A higher proportion of TT patients had liver metastases (46.3 vs 35.0%) and abnormal lactate dehydrogenase (61.1 vs 42.7%). IO-treated had a RECIST-determined response rate of 45.9 versus 60.1% for TT and time on treatment of 7.2 versus 11.4 months, respectively. There was no survival difference between cohorts. Despite higher risk patients, 1L TT resulted in higher response rate and longer treatment duration suggesting a preferred 1L sequence.
靶向治疗 (TT) 和免疫肿瘤学 (IO) 药物已获批用于治疗 BRAF 突变型转移性黑色素瘤 (MM) 患者。我们比较了一线 (1L) TT 与 1L IO 的真实世界疗效，以评估最佳治疗顺序。医生识别出开始接受 1L TT 或 IO 治疗的 BRAF 突变型 MM 患者，并提取了治疗、疾病和临床结局数据，包括疾病缓解情况，然后比较了 TT 和 IO 以及各个方案之间的差异。共确定了 440 例 MM 患者（TT=283 例，IO=157 例）。TT 组的肝转移比例（46.3%比 35.0%）和乳酸脱氢酶异常（61.1%比 42.7%）的患者比例更高。根据 RECIST 标准，TT 组和 IO 组的客观缓解率分别为 60.1%和 45.9%，治疗持续时间分别为 11.4 个月和 7.2 个月。两组的生存情况无差异。尽管 TT 组患者的风险更高，但 1L TT 治疗的缓解率更高，治疗持续时间更长，提示 TT 为优选的一线治疗方案。
