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恩考芬尼与比美替尼联合用药在日本BRAF突变型黑色素瘤患者中的上市后监测

Post-marketing surveillance of encorafenib in combination with binimetinib in Japanese patients with BRAF-mutant melanoma.

作者信息

Yamazaki Naoya, Sakata Hidenori, Iida Osamu, Katayama Teruaki, Uhara Hisashi

机构信息

Department of Dermatologic Oncology, National Cancer Center Hospital, Tokyo, Japan.

Department of Pharmacovigilance, Ono Pharmaceutical Co., Ltd, Osaka, Japan.

出版信息

Int J Clin Oncol. 2025 Apr;30(4):814-823. doi: 10.1007/s10147-025-02693-6. Epub 2025 Feb 7.

Abstract

BACKGROUND

A BRAF inhibitor, encorafenib, combined with a MEK inhibitor, binimetinib, was approved in Japan in early 2019 for the treatment of BRAF V600-mutant, unresectable malignant melanoma based on results of the global phase III trial, COLUMBUS, conducted in various countries including Japan. This post-marketing surveillance (PMS) assessed the combination in real-world clinical practice in Japan.

METHODS

We performed a prospective, multicentre, 12-month PMS of the safety and effectiveness of encorafenib plus binimetinib for radically unresectable, BRAF-mutant malignant melanoma in Japan.

RESULTS

Among 174 survey forms collected from 85 centres between February 2019 and August 2020, 172 were included for safety and effectiveness analysis. Patients (male [52.3%], median age 62.0 years) had Eastern Cooperative Oncology Group Performance Status 0 or 1 (91.8%) and comorbidities (55.2%). Respective encorafenib and binimetinib median dosages were 450 mg/day and 90 mg/day; median treatment duration, 24.1 and 24.2 weeks, and discontinuation, 71.5% for each, primarily for disease progression (56.9%) and adverse drug reactions (ADRs, 38.2%). Safety assessment ADRs occurred in 99 patients (57.6%), including eye disorders (40.7%), hepatic dysfunction (20.3%), rhabdomyolysis (4.7%), haemorrhage (2.3%), palmar-plantar erythrodysaesthesia syndrome (1.7%), and hypertension (1.7%); 19.8% were grade ≥ 3, none were grade 5, most resolved with/without treatment modification. At 12 months, the objective response rate was 48.8% (95% CI 41.2, 56.6; complete [19.2%], partial [29.7%]), overall survival was 40.1%.

CONCLUSION

The safety and effectiveness of encorafenib plus binimetinib in Japanese patients with BRAF-mutant malignant melanoma were similar to data reported in COLUMBUS; no new safety concerns were identified.

摘要

背景

一种BRAF抑制剂恩考芬尼与一种MEK抑制剂比美替尼联合用药,基于在包括日本在内的多个国家进行的全球III期试验COLUMBUS的结果,于2019年初在日本获批用于治疗BRAF V600突变的不可切除恶性黑色素瘤。本次上市后监测(PMS)评估了该联合用药在日本真实世界临床实践中的情况。

方法

我们对恩考芬尼加比美替尼治疗日本BRAF突变的不可切除恶性黑色素瘤的安全性和有效性进行了一项为期12个月的前瞻性、多中心PMS。

结果

在2019年2月至2020年8月期间从85个中心收集的174份调查问卷中,172份纳入安全性和有效性分析。患者(男性占52.3%,中位年龄62.0岁)东部肿瘤协作组体能状态为0或1(91.8%)且有合并症(55.2%)。恩考芬尼和比美替尼的中位剂量分别为450毫克/天和90毫克/天;中位治疗持续时间分别为24.1周和24.2周,停药率均为71.5%,主要原因是疾病进展(56.9%)和药物不良反应(ADR,38.)。安全性评估99例患者(57.6%)出现ADR,包括眼部疾病(40.7%)、肝功能障碍(20.3%)、横纹肌溶解(4.7%)、出血(2.3%)、手足红斑感觉异常综合征(1.7%)和高血压(1.7%);19.8%为≥3级,无5级,多数经调整治疗或未调整治疗后缓解。12个月时,客观缓解率为48.8%(95%CI 41.2,56.6;完全缓解[19.2%],部分缓解[29.7%]),总生存率为40.1%。

结论

恩考芬尼加比美替尼在日本BRAF突变恶性黑色素瘤患者中的安全性和有效性与COLUMBUS试验报告的数据相似;未发现新 的安全性问题。

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