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通过意大利管理准入计划,对手术切除后接受达拉非尼联合曲美替尼辅助治疗的高危 BRAF 突变黑色素瘤真实世界患者的特征分析

Characteristics of Real-World Patients with High-Risk -Mutated Melanoma Receiving Adjuvant Treatment with Dabrafenib Plus Trametinib After Surgical Resection, Through the Italian Managed Access Program.

作者信息

Quaglino Pietro, Ascierto Paolo A, Consoli Francesca, Queirolo Paola, Spagnolo Francesco, Morelli Maria Francesca, Berardi Rossana, Chiarion-Sileni Vanna, Tucci Marco, Troiani Teresa, Melotti Barbara, Rossi Ernesto, Mandala Mario, Rinaldi Gaetana, Marcon Ilaria Gioia, Pizzuti Matteo, Del Vecchio Michele

机构信息

Department of Medical Sciences, Dermatologic Clinic, University of Turin, Turin, Italy.

Department of Melanoma, Cancer Immunotherapy and Development Therapeutics, Istituto Nazionale Tumori IRCCS Fondazione Pascale, Naples, Italy.

出版信息

Cancer Manag Res. 2023 Nov 11;15:1271-1281. doi: 10.2147/CMAR.S423970. eCollection 2023.

Abstract

PURPOSE

Real-world data from patients with -mutated, resected, stage III melanoma treated with dabrafenib plus trametinib as adjuvant targeted therapy are limited, and it is important to gain an understanding of the characteristics of this patient population, as well as of the patient journey. Here we aimed to describe the characteristics, dosage reductions and discontinuations in patients with -mutated melanoma receiving adjuvant dabrafenib plus trametinib after surgical resection through an Italian managed access program (MAP).

PATIENTS AND METHODS

Eligible patients had completely resected cutaneous melanoma with confirmed V600E or V600K mutation, or initially resectable lymph node recurrence after a diagnosis of stage I or II melanoma. The starting dose of dabrafenib and trametinib was 150 mg twice daily and 2 mg once daily, respectively.

RESULTS

A total of 557 patients received dabrafenib plus trametinib through the MAP (stage III resected disease at inclusion, 554). Median age was 54.0 years, and 40.2% of patients were female. The proportion of all treated patients who required a dose reduction was low (10.8%) as was the proportion of patients who discontinued treatment (13.5%). The main reason for treatment discontinuation was adverse events (36.0%).

CONCLUSION

New treatments, including BRAF-targeted therapies and immunotherapy, have transformed the natural history of melanoma. This is the largest study to date describing patients treated with dabrafenib plus trametinib in routine clinical practice in Italy between 2018 and 2019. Results highlight the characteristics of the patients treated and their journey, as well as the tolerable safety profile of dabrafenib plus trametinib in a real-world patient population.

摘要

目的

接受达拉非尼联合曲美替尼作为辅助靶向治疗的BRAF突变、已切除的III期黑色素瘤患者的真实世界数据有限,了解该患者群体的特征以及患者病程很重要。在此,我们旨在通过意大利的管理式准入计划(MAP)描述手术切除后接受辅助达拉非尼联合曲美替尼治疗的BRAF突变黑色素瘤患者的特征、剂量减少和停药情况。

患者与方法

符合条件的患者为已完全切除的皮肤黑色素瘤,伴有确诊的V600E或V600K突变,或在I期或II期黑色素瘤诊断后最初可切除的淋巴结复发。达拉非尼和曲美替尼的起始剂量分别为每日两次,每次150 mg和每日一次,每次2 mg。

结果

共有557例患者通过MAP接受了达拉非尼联合曲美替尼治疗(纳入时为III期切除疾病,554例)。中位年龄为54.0岁,40.2%的患者为女性。所有接受治疗的患者中需要减少剂量的比例较低(10.8%),停药患者的比例也较低(13.5%)。停药的主要原因是不良事件(36.0%)。

结论

包括BRAF靶向治疗和免疫治疗在内的新治疗方法已经改变了黑色素瘤的自然病程。这是迄今为止描述2018年至2019年期间在意大利常规临床实践中接受达拉非尼联合曲美替尼治疗的患者的最大规模研究。结果突出了接受治疗的患者的特征及其病程,以及达拉非尼联合曲美替尼在真实世界患者群体中的可耐受安全性。

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