Atezolizumab Plus Vemurafenib/Cobimetinib for Patients With BRAF V600–Mutated Melanoma and CNS Metastases
Source: The ASCO Post, August 2022
In the phase II TRICOTEL study reported in The Lancet Oncology, Reinhard Dummer, MD, and colleagues found that the combination of atezolizumab plus vemurafenib and cobimetinib produced durable intracranial responses in patients with BRAF V600–mutated melanoma and central nervous system (CNS) metastases.
Study Details
In the trial, patients from sites in seven countries were enrolled between December 2018 and December 2020 into either a BRAF V600 wild-type cohort or a BRAF V600 mutation–positive cohort. The wild-type cohort received atezolizumab at 840 mg on days 1 and 15 of each 28-day cycle plus cobimetinib at 60 mg once daily on days 1 to 21. The mutation-positive cohort received atezolizumab at the same dosage, vemurafenib at 720 mg twice daily, and cobimetinib at the same dosage in 28-day cycles, with atezolizumab withheld in cycle 1.
The wild-type cohort was closed after enrollment of 15 patients following primary analysis of the phase III IMspire170 study; the study showed no improvement in progression-free survival with atezolizumab/cobimetinib vs pembrolizumab in BRAF V600 wild-type advanced melanoma. A total of 65 patients were enrolled in the mutation-positive cohort (5 did not receive atezolizumab).