The treatment of some patients with melanoma is promising

(CNN) – To treat melanoma, the most serious type of skin cancer, doctors have turned to surgery, chemotherapy, radiation therapy and even immunotherapy, among other options. treatment.

Yet, when it specifically refers to patients whose metastatic melanoma is linked to mutations in the BRAF gene, called V600E or V600K, the best treatment option for these patients was somewhat uncertain – until they reached the end of their life. now.

A first-line treatment with two types of anticancer drugs – dabrafenib, which inhibits BRAF, combined with an MEK inhibitor called trametinib – has proven to be beneficial in the long-term for about one-third of patients with long-term cancer. a melanoma with these genetic mutations, according to a new study published in the New England Journal of Medicine Tuesday. The study was presented simultaneously at the annual scientific meeting of the American Society for Clinical Oncology in Chicago.

According to the American Cancer Society, about half of melanomas show changes or mutations in the BRAF gene. The melanoma cells with these mutations produce a modified BRAF protein that helps them to develop and treat this cancer, some drugs target this protein and others related to it, such as MEK proteins.

Thus, if a patient with melanoma has a BRAF mutation and needs a targeted therapy to treat his cancer, he can receive a BRAF inhibitor drug, such as dabrafenib, as well as an MEK inhibitor drug, such as trametinib. – because the combination of these medications seems better using one or the other alone.

The new study included badysis of data from two previous trials evaluating adult patients with melanoma treated with dabrafenib and trametinib. Dabrafenib is sold under the brand name Tafinlar and trametinib is sold under the brand name Mekinist.

These data included 563 patients randomized to receive dabrafenib twice daily plus trametinib once daily. The pharmaceutical company GlaxoSmith-Kline sponsored both trials.

Five years after first-line treatment with dabrafenib plus trametinib, researchers found that 19% of patients were progression-free and their overall survival was 34%.

In comparison, in the dabrafenib plus placebo group and in the vemurafenib group, the five-year overall survival rate was 27% and 23%, respectively.

"Our badysis demonstrates that first-line treatment with Tafinlar + Mekinist can control the disease over five years in about one-fifth of patients and ensure five-year survival in about one-third of those treated," he said. Caroline Robert, director of the dermatology unit of the Gustave Roussy Institute in Paris, who was the first author of the study, said Tuesday in a press release.

"While metastatic melanoma has always had a very poor prognosis for patients, many reasons need to be encouraged today.Our badysis demonstrates a clinically significant and positive impact on patient survival.These results show that Targeted people can ensure long-term survival and deliver sustainable results, "she said.

Some adverse events led patients to discontinue the test, including fever, decreased pumping of blood in the heart and increased levels of a certain enzyme in the liver and kidneys.

"This study involves between half to 60% of patients with metastatic melanoma expressing BRAF V600E or V600.For these patients, a question mark was highlighted," said Dr. Otis Brawley, Distinguished Professor of 39 Oncology and Epidemiology at Johns Hopkins University in Baltimore. , who did not participate in the study.

"This study is well done and suggests that patients expressing markers are more likely to benefit from the combined two targeted treatments as a first treatment in place of immunotherapy .This clarifies the interrogation point", said Brawley.

"There is a second finding: the longer people have survived, the fewer relapses, suggesting that a small proportion of these patients are cured of melanoma," he said. declared. "In medical oncology, we are reluctant to use the word cure in speaking of metastatic solid tumors, but the fact that long-term survival curves flatten out is extremely encouraging."

Last year, the US Food and Drug Administration approved the combination of dabrafenib and trametinib for the treatment of melanoma patients with BRAF V600E or V600K mutations, as adjuvant therapy, and it is ie after the initial treatment.