Neoadjuvant Therapy Improves Event-Free Survival in High-Risk Melanoma

Source: Cancer Network, January 2018

Neoadjuvant treatment with dabrafenib and trametinib offered significantly improved event-free survival (EFS) over standard of care involving surgery and adjuvant therapy in patients with high-risk, surgically resectable melanoma, according to a phase II trial.
“Neoadjuvant therapy for melanoma has been restricted historically, mainly because of the low activity of chemotherapy in this disease,” wrote study authors led by Rodabe N. Amaria, MD, of the University of Texas MD Anderson Cancer Center in Houston. The group hypothesized that a combined approach targeting both BRAF and MEK might offer improved activity.
The new trial was a single-center, open-label, randomized, phase II study; it enrolled 7 patients to standard of care (upfront surgery and consideration for adjuvant therapy) and 14 to neoadjuvant dabrafenib and trametinib, but the trial was then stopped early after an interim analysis showed significantly longer EFS with the neoadjuvant approach. All patients included had surgically resectable clinical stage III or oligometastatic stage IV melanoma with BRAF mutations, and no previous exposure to BRAF or MEK inhibition; the results were published in Lancet Oncology.