Clinical Trials for Frontline Therapy in Melanoma

Source: OncLive, August 2019

Jeffrey S. Weber, MD, PhD: Jason, speaking of frontline targeted therapy, we now have longer-term data that will be presented at this ASCO [American Society of Clinical Oncology Annual Meeting]. I think it’s an oral presentation. What can you tell us about that abstract and what it says?

Jason J. Luke, MD, FACP: These are the 4- to 5-year follow-up data on dabrafenib-trametinib phase III clinical trials. And I think the data actually are pretty impressive, and I think it’s really worth highlighting them, although they have to be put into context. I always like the term that you often throw out about the urban legend that all patients who get targeted therapy eventually progress. I think what we can really, definitively say, based on this abstract, is that’s not true. At 4 and 5 years, we saw that the progression-free survival was around 20%. That means that about one-fifth of the patients never progressed on targeted therapy, and I think that’s really important. That really is a change from the way people have commonly thought of that. And the overall survival for those patients is sort of in the mid-30s, and that’s pretty good as well considering the historical experience in melanoma.

Another really important aspect of this, just to note, is the stratification within this analysis, which is to say that a low LDH [lactate dehydrogenase]—which is a blood biomarker that we use in melanoma—strongly stratified the outcomes of the patients. At 4 to 5 years, the patients with low LDH were 40% progression-free compared with those with a high LDH, who were less than 10%.

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