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WCCS/EADO 2016 | BRIM-3 trial in melanoma: prognostic factors of overall survival and the issue of salvage therapies

Axel Hauschild, MD, PhD of University Hospital Schleswig-Holstein, Kiel, Germany, discusses the evaluation of long-term survival and prognostic subgroups of overall survival (OS) for the BRIM-3 trial of vemurafenib in BRAF-muated metastatic melanoma patients (NCT01006980) at the 2016 World Congress on Cancers of the Skin (WCCS) and the Congress of the European Association of Dermato-Oncology (EADO) in Vienna, Austria. The long-term survival data will be released soon but there are no big surprises according to Prof. Hauschild. As seen in the pooled analysis of prognostic subgroups of overall survival, which included the BRIM-3 study, this showed that patients with low LDH (lactate dehydrogenase) at baseline do well and patients with high LDH at baseline are not doing as well. Further, all the results, whether with dabrafenib and tremetinib or vemurafenib and cobimetinib, are impacted by salvage therapies. If the patient has progressive disease and you give another agent, which affects overall survival, this means that in the end, it will be difficult to say which drug caused long-term survival. This question needs to be addressed according to Prof. Hauschild in order to find the right sequence of drugs.