ASCO 2025 | Final results from DREAMseq in BRAFV600-mutant metastatic melanoma
Michael Atkins, MD, FASCO, Georgetown Lombardi Comprehensive Cancer Center, Washington, DC, discusses updated outcomes from the DREAMseq trial (NCT02224781), which compared initial treatment with nivolumab and ipilimumab versus dabrafenib and trametinib in patients with treatment-naïve BRAFV600-mutant metastatic melanoma. Nearly five years of follow-up confirmed a sustained overall survival advantage with the immunotherapy-first approach. Although response rates were similar, durability of response and progression-free survival favored the nivolumab and ipilimumab sequence. This interview took place during the 2025 American Society of Clinical Oncology (ASCO) Meeting in Chicago, IL.
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Transcript
In the five-year data, we show that going out to five years, there’s now a 30% absolute survival benefit favoring immunotherapy first. Essentially, 60% of patients are alive on immunotherapy versus 30% who started with targeted therapy and a tripling of the PFS benefit. And when we looked at all the various subsets of patients, including those we stratified for based on LDH or performance status, looking at gender, looking at age, looking at what we would consider good prognostic features, which are the patients who are purported to do best with targeted therapy...
In the five-year data, we show that going out to five years, there’s now a 30% absolute survival benefit favoring immunotherapy first. Essentially, 60% of patients are alive on immunotherapy versus 30% who started with targeted therapy and a tripling of the PFS benefit. And when we looked at all the various subsets of patients, including those we stratified for based on LDH or performance status, looking at gender, looking at age, looking at what we would consider good prognostic features, which are the patients who are purported to do best with targeted therapy. All of them do better in terms of four-year PFS and four-year overall survival by getting immunotherapy first.
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Disclosures
Leadership – Werewolf Therapeutics
Stock and Other Ownership Interests – Pyxis; Werewolf Pharma
Consulting or Advisory Role – 23AndMe; Abbvie; Agenus; AstraZeneca; Aveo; BeiGene; Boehringer Ingelheim; Bristol-Myers Squibb; Eisai; Exelixis; Genentech; Innovent Biologics; IO Biotech; Jazz Pharmaceuticals; Merck; Novartis; Oncorena; Pfizer; Pliant; Pyxis; Replimune; Sanofi; Simcha Therapeutics; Syncona; Werewolf Pharma
Research Funding – Agenus (Inst); Bristol-Myers Squibb (Inst); Merck (Inst)
Travel, Accommodations, Expenses – BMS Canada; BMS Sweden
