Department of Internal Medicine, Medical Oncology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico , Milano, Italy.
Unit of Medical Oncology, Department of Oncology and Hematology, Papa Giovanni XXIII Hospital, Bergamo, Italy.
Expert Opin Drug Saf. 2020 Oct;19(10):1229-1236. doi: 10.1080/14740338.2020.1817376. Epub 2020 Sep 14.
Approximately 40-50% of patients with cutaneous melanoma harbor point mutations in . BRAF and MEK inhibitors in combination are now a standard therapy for advanced -mutated melanoma. Nevertheless, survival rates with the combination are limited, highlighting the need for further therapeutic improvement and strategies to overcome primary and acquired resistance.
Encorafenib, a highly selective BRAF inhibitor, was developed in combination with binimetinib, a potent, selective allosteric MEK1/2 inhibitor, to improve efficacy and tolerability over other approved combo-targeted therapies. This novel combination shows peculiar pharmacodynamic properties which translate in a higher on-target potency and paradox index. Consistent survival improvements for encorafenib and binimetinib in -mutated melanoma have been confirmed in clinical trials, with over 4 years of median follow up.
the favorable survival results and the attractive toxicity profile suggest that encorafenib and binimetinib combination is an intriguing standard option when targeted therapies are considered as first line treatment in BRAF mutated melanoma patients. In the near future, results from ongoing clinical trials will provide information on the use of this novel combination in specific situation, including as adjuvant treatment or as a combination strategy.
约 40-50%的皮肤黑色素瘤患者存在. BRAF 点突变,BRAF 和 MEK 抑制剂联合治疗现已成为晚期. 突变型黑色素瘤的标准治疗方法。然而,联合治疗的生存率有限,这突出表明需要进一步的治疗改善和策略来克服原发性和获得性耐药。
encorafenib 是一种高度选择性的 BRAF 抑制剂,与 binimetinib 联合开发,后者是一种强效、选择性的别构 MEK1/2 抑制剂,旨在提高疗效和耐受性,优于其他已批准的联合靶向治疗。这种新的组合具有独特的药效学特性,表现为更高的靶标效力和悖论指数。在临床试验中,encorafenib 和 binimetinib 在. 突变型黑色素瘤中的生存改善得到了证实,中位随访时间超过 4 年。
良好的生存结果和有吸引力的毒性特征表明,encorafenib 和 binimetinib 联合治疗是一种有趣的标准选择,当靶向治疗被认为是 BRAF 突变型黑色素瘤患者的一线治疗时。在不久的将来,正在进行的临床试验的结果将提供关于在特定情况下使用这种新组合的信息,包括辅助治疗或联合治疗策略。