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ASCO 2025 | Primary analysis of Columbus-AD: encorafenib and binimetinib in high-risk stage II melanoma

Alexander Van Akkooi, MD, PhD, of Melanoma Institute Australia, Sydney, Australia, comments on the primary analysis of the Phase III Columbus-AD trial (NCT05270044), which investigated the safety and efficacy of encorafenib and binimetinib in the adjuvant treatment of BRAF-mutated stage II melanoma. The trial demonstrated the safety profile is consistent with previous trials, as well as promising results for recurrence-free and distant metastasis-free survival. Unfortunately, the trial recruitment was prematurely terminated, leaving it unable to seek formal regulatory approvals. However, Dr Van Akkooi notes that the results may still lead to access and reimbursement for encorafenib and binimetinib in some countries. This interview took place during the 2025 American Society of Clinical Oncology (ASCO) Meeting in Chicago, IL.

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Transcript

The primary analysis of the Columbus-AD trial is looking at the safety and efficacy of encorafenib and binimetinib in the adjuvant treatment of BRAF mutant stage 2 melanoma, primarily looking at safety. The safety profile found is very consistent with what we know for encorafenib and binimetinib in other stages of disease like in stage 4 melanoma or other indications, and it’s been a very tolerable treatment...

The primary analysis of the Columbus-AD trial is looking at the safety and efficacy of encorafenib and binimetinib in the adjuvant treatment of BRAF mutant stage 2 melanoma, primarily looking at safety. The safety profile found is very consistent with what we know for encorafenib and binimetinib in other stages of disease like in stage 4 melanoma or other indications, and it’s been a very tolerable treatment. We also performed descriptive analyses for recurrence-free and distant metastasis-free survival, showing very promising results in that end. The promising results for recurrence-free survival and distant metastasis-free survival show a trend towards a 10-20% improvement for encorafenib and binimetinib over placebo. So unfortunately, the trial recruitment has been prematurely terminated, leaving us with only 110 patients out of the 800 that were initially planned, meaning that this is no longer a registrational trial. So unfortunately, we will not go to the regulatory authorities to get formal approvals. However, in some countries, this will be possible to get access and reimbursement for encorafenib and binimetinib for this indication based off of these results. It would have been ideal to have the option to offer different treatments like PD-1 or encorafenib and binimetinib for stage 2 melanoma patients, but unfortunately we’ll have to wait for another BRAF/MEK combination compound to come through in the future.

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Disclosures

Honoraria / Consultancy or Advisory Role: Amgen, Bristol-Myers Squibb, Genmab, Menarini Silicon Biosystems, Merck Serono-Pfizer, MSD Merck, Neracare, Novartis, Pierre Fabre, Provectus, Sanofi, Sirius Medical, SkylineDx, 4SC; Research Funding Amgen, Merck Serono – Pfizer, SkylineDx.