Cessation of targeted therapy after a complete response in BRAF-mutant advanced melanoma: a case series

Br J Cancer. 2016 Nov 22;115(11):1280-1284. doi: 10.1038/bjc.2016.321. Epub 2016 Oct 6.

Abstract

Background: It is unknown whether melanoma patients achieving complete response (CR) with targeted therapy can safely discontinue treatment.

Methods: All patients treated with BRAF/MEK inhibitors achieving CR and ceasing treatment before progression were identified. Clinical data at treatment initiation, cessation and progression were examined.

Results: A total of 12 eligible patients were identified, with median follow-up of 16 months, of whom 6 (50%) recurred at a median of 6.6 months after treatment cessation. One patient lost to follow-up until presentation with symptomatic recurrence was the only relapser to die. At relapse, the remaining five patients had an LDH <1.2 times ULN, four were ECOG 0 and one ECOG 1. Baseline characteristics and time to CR and to discontinuation did not influence the rate of relapse.

Conclusions: A large proportion of patients achieving CR with BRAF/MEK inhibitors relapse after treatment cessation. The optimal treatment duration in such patients is unclear, particularly where alternative treatments are available.

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Agents / therapeutic use*
  • Female
  • Humans
  • Male
  • Melanoma / drug therapy*
  • Melanoma / genetics
  • Middle Aged
  • Mutation*
  • Proto-Oncogene Proteins B-raf / antagonists & inhibitors
  • Proto-Oncogene Proteins B-raf / genetics*
  • Recurrence
  • Survival Analysis

Substances

  • Antineoplastic Agents
  • BRAF protein, human
  • Proto-Oncogene Proteins B-raf