Targeted therapies before and after surgery delay melanoma progression
A pair of targeted therapies given before and after surgery for melanoma produced at least a six-fold increase in time to progression compared to standard-of-care surgery for patients with stage 3 disease, MD Anderson researchers found in a recent study. Patients who had no sign of disease at surgery after combination treatment did not progress to metastasis.
Early results of the study comparing surgery to pre- and post-surgical treatment with the BRAF inhibitor dabrafenib and the MEK inhibitor trametinib were so strikingly positive that MD Anderson’s data safety monitoring board ordered the randomized, prospective Phase II trial halted and changed to a single-arm using the combination.
“These results are encouraging for patients with surgically resectable stage 3 melanoma who face a high rate of relapse and progression to metastatic disease,” said lead author Rodabe Amaria, M.D., assistant professor of Melanoma Medical Oncology. “Our proof-of-concept study strongly supports further assessment of neoadjuvant (presurgical) therapy for this high-risk population, which has a five-year survival rate of less than 50 percent.”
The targeted combination is approved by the U.S. Food and Drug Administration for stage 4 metastatic melanoma that features a BRAFV600 mutation. Amaria, senior author Jennifer Wargo, M.D., associate professor of Surgical Oncology and Genomic Medicine, and colleagues hypothesized that the combination could help patients with stage 3 BRAF-mutant disease.
Most melanoma is detected at early stages and treated successfully with surgery, but about 15 percent of patients progress to stage 3, when the disease has spread to lymph nodes.
Rodabe Amaria, M.D., assistant professor of Melanoma Medical Oncology, is the lead author on a study that showed targeted therapies given before and after surgery for melanoma delayed the progression of the disease.