Pembrolizumab use supported in advanced melanoma
Use of pembrolizumab is supported among patients with advanced melanoma, regardless of BRAF V600E/K mutation status or prior receipt of a BRAF inhibitor (BRAFi) with or without MEK inhibitor (MEKi) therapy, according to a study published online July 20 in JAMA Oncology.
Igor Puzanov, M.D., from Roswell Park Cancer Institute in Buffalo, New York, and colleagues used a post hoc subgroup analysis of pooled data to examine the association of BRAF wild-type (WT) or BRAF V600E/K-mutant status and prior BRAFi receipt with or without MEKi therapy with response to pembrolizumab among 1,558 patients with advanced melanoma from three multisite studies.
The researchers found that in the overall study population, the objective response rate (ORR), four-year progression-free survival (PFS) rate, and four-year overall survival (OS) rate were 38.3, 22.0, and 36.9 percent, respectively. For 1,124 patients with BRAF WT and 434 with BRAF V600E/K-mutant melanoma, the ORRs were 39.8 and 34.3 percent, respectively; four-year PFS rates were 22.9 and 19.8 percent, respectively; and four-year OS rates were 37.5 and 35.1 percent, respectively. Patients with BRAF V600E/K-mutant melanoma who had or had not previously received BRAFi with or without MEKi therapy had ORRs of 28.4 and 44.2 percent, respectively; four-year PFS rates of 15.2 and 27.8 percent, respectively; and four-year OS rates of 26.9 and 49.3 percent, respectively.
“The 1,558 patients pooled from three pivotal trials form, to our knowledge, the largest data set reported for this critical analysis of the association of BRAF V600E/K mutation and prior BRAF-directed therapy with therapeutic outcomes of single-agent programmed death 1 blockade,” the authors write.
Several authors disclosed financial ties to biopharmaceutical companies, including Merck, which manufactures pembrolizumab and provided funding for the study.