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Gonzalez-Cao M, Mayo de Las Casas C, Oramas J, Berciano-Guerrero MA, de la Cruz L, Cerezuela P, Arance A, Muñoz-Couselo E, Espinosa E, Puertolas T, Diaz Beveridge R, Ochenduszko S, Villanueva MJ, Basterretxea L, Bellido L, Rodriguez D, Campos B, Montagut C, Drozdowskyj A, Molina MA, Lopez-Martin JA, Berrocal A. Intermittent BRAF inhibition in advanced BRAF mutated melanoma results of a phase II randomized trial. Nat Commun 2021; 12:7008. [PMID: 34853302 PMCID: PMC8636498 DOI: 10.1038/s41467-021-26572-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 10/08/2021] [Indexed: 11/28/2022] Open
Abstract
Combination treatment with BRAF (BRAFi) plus MEK inhibitors (MEKi) has demonstrated survival benefit in patients with advanced melanoma harboring activating BRAF mutations. Previous preclinical studies suggested that an intermittent dosing of these drugs could delay the emergence of resistance. Contrary to expectations, the first published phase 2 randomized study comparing continuous versus intermittent schedule of dabrafenib (BRAFi) plus trametinib (MEKi) demonstrated a detrimental effect of the “on−off” schedule. Here we report confirmatory data from the Phase II randomized open-label clinical trial comparing the antitumoral activity of the standard schedule versus an intermittent combination of vemurafenib (BRAFi) plus cobimetinib (MEKi) in advanced BRAF mutant melanoma patients (NCT02583516). The trial did not meet its primary endpoint of progression free survival (PFS) improvement. Our results show that the antitumor activity of the experimental intermittent schedule of vemurafenib plus cobimetinib is not superior to the standard continuous schedule. Detection of BRAF mutation in cell free tumor DNA has prognostic value for survival and its dynamics has an excellent correlation with clinical response, but not with progression. NGS analysis demonstrated de novo mutations in resistant cases. Whether intermittent strategies of delivering drugs can improve cancer patients survival is still unclear. Here, the authors reports the results of a randomized phase II clinical trial aimed to compare the efficacy and safety of two dosing regimens (continuous and intermittent) of vemurafenib and cobimetinib combination as first-line treatment of patients with unresectable or metastatic advanced melanoma with BRAFV600 mutation
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Affiliation(s)
- Maria Gonzalez-Cao
- Translational Cancer Research Unit, Instituto Oncologico Dr Rosell, Dexeus University Hospital, Barcelona, Spain.
| | - Clara Mayo de Las Casas
- Translational Cancer Research Unit, Instituto Oncologico Dr Rosell, Dexeus University Hospital, Barcelona, Spain
| | - Juana Oramas
- Hospital Universitario de Canarias, Tenerife, Spain
| | - Miguel A Berciano-Guerrero
- Hospitales Universitarios Regional y Virgen de la Victoria (HURyVV). Instituto de Investigaciones Biomédicas de Málaga (IBIMA), Málaga, Spain
| | | | - Pablo Cerezuela
- Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
| | | | | | | | | | | | | | | | | | | | | | | | | | - Ana Drozdowskyj
- Translational Cancer Research Unit, Instituto Oncologico Dr Rosell, Dexeus University Hospital, Barcelona, Spain
| | - Miguel A Molina
- Translational Cancer Research Unit, Instituto Oncologico Dr Rosell, Dexeus University Hospital, Barcelona, Spain
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Alba-Linero C, Rocha De Lossada C, Delgado-Fernández AS, Jódar-Márquez M, Rodríguez Calvo De Mora M, Berciano-Guerrero MA. Pseudovitelliform maculopathy secondary to BRAF and MEK inhibitors in a patient with metastasic melanoma. J BIOL REG HOMEOS AG 2019; 33:1497-1500. [PMID: 31583878 DOI: 10.23812/19-89-l] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- C Alba-Linero
- Ophthalmology Department, Hospital Regional Málaga, Plaza del Hospital Civil, Málaga, Spain
| | - C Rocha De Lossada
- Ophthalmology Department, Hospital Regional Málaga, Plaza del Hospital Civil, Málaga, Spain
| | - A S Delgado-Fernández
- Ophthalmology Department, Hospital Regional Málaga, Plaza del Hospital Civil, Málaga, Spain
| | - M Jódar-Márquez
- Ophthalmology Department, Hospital Regional Málaga, Plaza del Hospital Civil, Málaga, Spain
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Berciano-Guerrero MA, Montesa-Pino A, Castaneda-Penalvo G, Munoz-Fernandez L, Rodriguez-Flores J. Nanoparticles in melanoma. Curr Med Chem 2015; 21:3701-16. [PMID: 25039783 DOI: 10.2174/0929867321666140716092512] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Revised: 04/29/2014] [Accepted: 07/11/2014] [Indexed: 11/22/2022]
Abstract
Malignant melanoma is one of the most common causes of cancer and cancer deaths in young people. Until few years ago, scarce drugs have proven efficacy in metastatic setting. However, in the recent years, the treatment of metastatic malignant melanoma has undergone the incorporation of effective treatment such as immunotherapy, the use of tyrosine kinase inhibitors and the emergence of other cytostatic compounds, like the nanoparticles. This review aims to propose a standardization to classify the different types of nanoparticles, according to chemical aspects, and update the clinical research with nanoparticles and their use in melanoma field.
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Affiliation(s)
| | | | | | | | - J Rodriguez-Flores
- Medical Oncology Section, Hospital Regional Universitario Carlos Haya, Malaga, Avda. Carlos Haya s/n; 29010 Malaga, Spain.
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