Atezolizumab, Vemurafenib, and Cobimetinib in Patients With BRAF V600–Mutated Melanoma and CNS Metastases

Source: The Asco Post, July 2023

A revised report of findings from the phase II TRICOTEL study of atezolizumab, vemurafenib, and cobimetinib in patients with melanoma and central nervous system (CNS) metastases was published in The Lancet Oncology by Reinhard Dummer, MD, and colleagues. The first version of trial findings, published online in August 2022, was retracted. In the modified report, the study continued to show that the triplet demonstrated intracranial activity in this patient population.

As stated by the editors of The Lancet Oncology, “[We] republish a corrected version along with a revised appendix, in which the findings have changed—for example, the intracranial response rate for patients with symptomatic CNS metastases, a post-hoc subgroup analysis, is lower than previously reported and thus the combination of atezolizumab, vemurafenib, and cobimetinib no longer appears to provide substantially improved efficacy over targeted therapy alone in this subset of patients. Of note, however, the primary endpoint has not changed and the overall message of the paper is broadly similar to the previous version.”
Study Details

In the trial, previously untreated patients with metastatic melanoma and brain metastases of ? 5 mm in at least one dimension were enrolled from sites in Brazil, France, Germany, Hungary, Italy, Spain, and Switzerland between December 2018 and December 2020. A total of 65 patients were enrolled in a BRAF V600 mutation–positive cohort; a BRAF V600 wild-type cohort was closed early after enrollment of 15 patients (following primary analysis of the phase III IMspire170 study of cobimetinib plus atezolizumab in BRAF V600 wild-type melanoma).