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辅助达拉非尼和曲美替尼治疗 BRAF 突变型黑色素瘤切除后的患者:DESCRIBE-AD 真实世界回顾性观察研究。

Adjuvant dabrafenib and trametinib for patients with resected BRAF -mutated melanoma: DESCRIBE-AD real-world retrospective observational study.

机构信息

Medical Oncology, Instituto Catalán de Oncología, ICO-Badalona, H. Germans Trias i Pujol, Badalona.

Medical Oncology, Catalan Institute of Oncology (ICO) L'Hospitalet.

出版信息

Melanoma Res. 2023 Oct 1;33(5):388-397. doi: 10.1097/CMR.0000000000000888. Epub 2023 Mar 28.

Abstract

BRAF and MEK inhibitor, dabrafenib plus trametinib, adjuvant therapy is effective for high-risk resected melanoma patients with BRAF - V600 mutations. However, real-world evidence is limited. We aimed to determine the feasibility of this therapy in routine clinical practice. DESCRIBE-AD, a retrospective observational study, collected real-world data from 25 hospitals in Spain. Histologically confirmed and resected BRAF -mutated melanoma patients aged ≥18 years who were previously treated with dabrafenib plus trametinib adjuvant therapy, were included. The primary objectives were treatment discontinuation rate and time to discontinuation. The secondary objectives included safety and efficacy. From October 2020 to March 2021, 65 patients were included. Dabrafenib and trametinib discontinuation rate due to treatment-related adverse events (TRAEs) of any grade was 9%. Other reasons for discontinuation included patients' decisions (6%), physician decisions (6%), unrelated adverse events (3%), disease progression (5%), and others (5%). The median time to treatment discontinuation was 9 months [95% confidence interval (CI), 5-11]. G3-4 TRAEs occurred in 21.5% of patients, the most common being pyrexia (3%), asthenia (3%), and diarrhoea (3%). Unscheduled hospitalisations and clinical tests occurred in 6 and 22% of patients, respectively. After 20-month median follow-up (95% CI, 18-22), 9% of patients had exitus due to disease progression, with a 12-month relapse-free survival and overall survival rates of 95.3% and 100%, respectively. Dabrafenib and trametinib adjuvant therapy proved effective for melanoma patients in a real-world setting, with a manageable toxicity profile. Toxicity frequencies were low leading to low incidence of unscheduled medical visits, tests, and treatment discontinuations.

摘要

BRAF 和 MEK 抑制剂,达拉非尼联合曲美替尼,辅助治疗对存在 BRAF-V600 突变的高危可切除黑色素瘤患者有效。然而,真实世界的数据有限。我们旨在确定该疗法在常规临床实践中的可行性。DESCRIBE-AD 是一项回顾性观察性研究,从西班牙 25 家医院收集真实世界的数据。纳入年龄≥18 岁、组织学证实且可切除的 BRAF 突变黑色素瘤患者,这些患者先前接受过达拉非尼联合曲美替尼辅助治疗。主要终点为治疗停药率和停药时间。次要终点包括安全性和疗效。2020 年 10 月至 2021 年 3 月,共纳入 65 例患者。达拉非尼和曲美替尼因任何级别 TRAE 停药的停药率为 9%。其他停药原因包括患者决定(6%)、医生决定(6%)、无关不良事件(3%)、疾病进展(5%)和其他(5%)。中位停药时间为 9 个月[95%置信区间(CI):5-11]。38 例(21.5%)患者发生 3 级或 4 级 TRAE,最常见的是发热(3%)、乏力(3%)和腹泻(3%)。分别有 6%和 22%的患者发生计划外住院和临床检查。中位随访 20 个月(95%CI:18-22)后,9%的患者因疾病进展而死亡,12 个月无复发生存率和总生存率分别为 95.3%和 100%。达拉非尼联合曲美替尼辅助治疗在真实世界环境中对黑色素瘤患者有效,且毒性谱可管理。毒性频率较低,导致计划外就诊、检查和治疗中断的发生率较低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9177/10470432/de0eccf7b40c/mr-33-388-g001.jpg

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