Neoadjuvant therapy with trametinib and dabrafenib in high risk resectable BRAF-mutant melanoma

Rodabe N. Amaria, MD from the University of Texas MD Anderson Cancer Center, Houston, TX summarizes results on a recent randomized Phase II clinical trial of neoadjuvant treatment with BRAF and MEK inhibitors for melanoma (NCT02231775) she presented at the European Cancer Congress of the European Cancer Organisation (ECCO) 2017 in Amsterdam, Netherlands. Results from this trial on patients with clinical Stage III and oligometastatic Stage IV melanoma with the BRAF mutation indicate that neoadjuvant treatment with dabrafenib and trametinib resulted in a significant improvement in relapse-free survival (RFS) compared to standard of care treatment consisting of initial surgery followed by adjuvant therapy. Dr Amaria discusses how this highly significant improvement observed led to early closure of the trial, which is now continuing focusing solely on patients treated with neoadjuvant therapies. Blood and tumor biomarkers will be assessed throughout the treatment time course to investigate early predictors of response and resistance to treatment. Particularly the concept of pathologic complete response (pCR), where the tumor dies entirely at the time of surgery because of neoadjuvant therapy, and correlations between pathologic complete response and relapse-free survival as well as overall survival (OS), will be studied.

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