Interim analysis for post-marketing surveillance of dabrafenib and trametinib combination therapy in Japanese patients with unresectable and metastatic melanoma with BRAF V600 mutation

• Published in: International journal of clinical oncology 2020-10, Vol.25 (10), p.1870-1878
• Main Authors: Teshima, Yasutomo, Kizaki, Minako, Kurihara, Ryohei, Kano, Ryosuke, Harumiya, Miki
• Format: Article
• Language: English
• Subjects: Cancer Research; Clinical trials; Combination therapy; Creatine; Creatine kinase; Erythema; Erythema nodosum; Fever; L-Lactate dehydrogenase; Lactic acid; Medicine; Medicine & Public Health; Melanoma; Metastases; Metastasis; Mutation; Oncology; Original; Original Article; Patients; Point mutation; Safety; Surgical Oncology; Surveillance; Targeted cancer therapy
• ISSN: 1341-9625; 1437-7772
• DOI: 10.1007/s10147-020-01737-3

Purpose To investigate the safety and efficacy of dabrafenib and trametinib combination therapy for BRAF V600 mutation-positive unresectable and metastatic melanoma in over 100 Japanese patients of a real-world clinical setting. Patients The surveillance period of interim post-marketing surveillance (PMS) analysis was from June 2016 to November 2018, and 112 patients with unresectable and metastatic BRAF V600 melanoma who received dabrafenib and trametinib were enrolled. Results The safety analysis set included 112 patients whom almost all patients had stage IV disease ( n  = 97, 86.61%) with an Eastern Cooperative Oncology Group performance status 0 or 1 ( n  = 102, 91.07%), and mean (standard deviation) lactate dehydrogenase level was 354.3 (456.4) U/L ( n  = 105) at baseline. Median daily dose of dabrafenib was 300.0 mg/day (118–300), and median daily dose of trametinib was 2.00 mg/day (1.0–4.0). Adverse drug reactions (ADRs) were reported in 84 patients (75%), and common ADRs (incidence ≥ 5%) were pyrexia ( n  = 49, 43.75%), hepatic function abnormal ( n  = 11, 9.82%), rash and blood creatine phosphokinase increased ( n  = 9 each, 8.04%), and erythema nodosum ( n  = 6, 5.36%). Majority of ADRs reported in this study were consistent with that reported in previous trials. In the efficacy analysis set of 110 patients, the objective response rate was 55.45% (95% confidence interval 45.67–64.93%), and median progression-free survival was 384.0 days (251.0 days-not reached). Conclusions No new safety or efficacy concerns were observed in this interim PMS analysis in Japanese patients with unresectable and metastatic melanoma with BRAF gene mutation who received dabrafenib and trametinib combination therapy.