Immunotherapy Improves Survival in Advanced BRAF-Mutated Melanoma

Combination immunotherapy more successful in treating advanced skin cancer.

An immunotherapy showed promise in individuals with advanced BRAF-mutated melanoma by improving survival and lowering the risk of life-threatening events.

Melanoma is an aggressive and lethal form of skin cancer that in its early stages can usually be cured with surgery alone. However, patients who catch the disease late cannot opt for surgery, and drug therapy is the main course of treatment.

Cutaneous melanoma accounts for 3.3% of new cancer cases each year in Canada, and has a 15% death rate, according to the Canadian Cancer Society. Additionally, researchers stated that about 40% to 60% of melanomas have a mutation in the BRAF protein.

Although there are several effective treatment options available to patients with advanced BRAF-mutated melanoma, such as targeted therapy and immunotherapy, it’s remained unclear on which is the best initial treatment.

For a study published in JAMA Oncology, researchers wanted to estimate the relative safety and efficacy of systemic therapies for individuals with advanced BRAF-mutated melanoma who have not yet received treatment.

Researchers assessed 15 randomized controlled clinical trials that had been published between 2011 and 2015. In 6662 patients with distant metastatic melanoma who did not have surgery as an option, researchers examined the benefits and harms of targeted or immune checkpoint inhibitors.

The results of the study showed that combined BRAF and MEK targeted therapy and PD-1 immunotherapy were both equally effective in the improvement of overall survival. Combining BRAF and MEK inhibition was found to be most effective in improving progression-free survival, while PD-1 inhibition was associated with the lowest risk of life-threatening events.

“This is the first analysis to draw comparison between targeted and immune therapies for BRAF-mutated melanomas,” said principal study investigator Feng Xie. “Our results will help patients and clinicians choose treatments.”

The findings indicated that the safety of PD-1 inhibitors supports the use of this treatment option as first-line therapy in situations where quick action is not a priority.

“While the data in our study represents best available evidence, using more than 1 kind of immunotherapy shows promise in early outcomes in clinical trials and could change the treatment landscape once longer-term results are published,” Xie said.