Two-therapy combo can help melanoma patients live longer

A new study has suggested that combining two targeted therapies results in melanoma patients living significantly longer.

Results from a trial of a combination of two targeted therapies (dabrafenib and trametinib) to treat advanced melanoma have shown that patients are living significantly longer on the combined therapy than patients treated with another drug, vemurafenib, when used alone.

Caroline Robert, of the Institut Gustave Roussy, Paris, France, will tell the 2015 European Cancer Congress today (Monday) that not only is the median overall survival time longer for patients receiving the combination treatment, but also that 51 percent of patients receiving the combination treatment are alive after two years, compared to 38 percent of patients receiving vemurafenib alone.

Analysis of data up to 13 March 2015 showed that the median overall survival time among patients with metastatic melanoma harbouring V600 mutations in the BRAF gene who received the combination treatment was 25.6 months. Among patients receiving vemurafenib alone, it was 18 months. On the basis of this finding, the European Commission approved the combination of dabrafenib and trametinib for use in Europe for these patients on 1 September 2015 [2].

Researchers observed a statistically significant reduction of 34 percent in the risk of death among patients receiving the combination therapy, Robert will say. The increased survival among these patients is remarkable, and this median overall survival of more than two years is the longest in this category of patients in a phase III randomised trial.

This combination therapy is already available in the US and now also in Europe as a result of the European Commission's decision to approve its use. This long-term benefit in terms of overall survival confirms the major potential of this combination in patients with metastatic melanoma. A further question to investigate is the combination treatment versus new immunotherapies or combined with them, concluded Robert.

ESMO spokesperson, Reinhard Dummer, head of the skin cancer centre at the UniversitatsSpital Zurich (Switzerland), said that pre-clinical and translational research had suggested that dual pathway inhibition might improve the outcome of targeted therapy in BRAF mutated advanced melanoma.

Dummer noted that this trial now impressively shows the improved response rate, progression-free and overall survival, with an excellent tolerability. Based on this study, dual pathway inhibition must be integrated into the management algorithms for this patient population.