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

Matteo S. Carlino, Vito Vanella, Christina Girgis, Diana Giannarelli, Alex Guminski, Lucia Festino, Richard F. Kefford, Alexander M. Menzies, Georgina V. Long, Paolo A. Ascierto

Research output: Contribution to journalArticleResearchpeer-review

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.

LanguageEnglish
Pages1280-1284
Number of pages5
JournalBritish Journal of Cancer
Volume115
Issue number11
DOIs
Publication statusPublished - 22 Nov 2016

Fingerprint

Melanoma
Withholding Treatment
Recurrence
Mitogen-Activated Protein Kinase Kinases
Therapeutics
Lost to Follow-Up

Keywords

  • melanoma
  • BRAF inhibitors
  • MEK inhibitors
  • complete response
  • duration of response
  • treatment cessation

Cite this

Carlino, M. S., Vanella, V., Girgis, C., Giannarelli, D., Guminski, A., Festino, L., ... Ascierto, P. A. (2016). Cessation of targeted therapy after a complete response in BRAF-mutant advanced melanoma: A case series. British Journal of Cancer, 115(11), 1280-1284. https://doi.org/10.1038/bjc.2016.321
Carlino, Matteo S. ; Vanella, Vito ; Girgis, Christina ; Giannarelli, Diana ; Guminski, Alex ; Festino, Lucia ; Kefford, Richard F. ; Menzies, Alexander M. ; Long, Georgina V. ; Ascierto, Paolo A. / Cessation of targeted therapy after a complete response in BRAF-mutant advanced melanoma : A case series. In: British Journal of Cancer. 2016 ; Vol. 115, No. 11. pp. 1280-1284.
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Carlino, MS, Vanella, V, Girgis, C, Giannarelli, D, Guminski, A, Festino, L, Kefford, RF, Menzies, AM, Long, GV & Ascierto, PA 2016, 'Cessation of targeted therapy after a complete response in BRAF-mutant advanced melanoma: A case series', British Journal of Cancer, vol. 115, no. 11, pp. 1280-1284. https://doi.org/10.1038/bjc.2016.321

Cessation of targeted therapy after a complete response in BRAF-mutant advanced melanoma : A case series. / Carlino, Matteo S.; Vanella, Vito; Girgis, Christina; Giannarelli, Diana; Guminski, Alex; Festino, Lucia; Kefford, Richard F.; Menzies, Alexander M.; Long, Georgina V.; Ascierto, Paolo A.

In: British Journal of Cancer, Vol. 115, No. 11, 22.11.2016, p. 1280-1284.

Research output: Contribution to journalArticleResearchpeer-review

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T1 - Cessation of targeted therapy after a complete response in BRAF-mutant advanced melanoma

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AU - Carlino, Matteo S.

AU - Vanella, Vito

AU - Girgis, Christina

AU - Giannarelli, Diana

AU - Guminski, Alex

AU - Festino, Lucia

AU - Kefford, Richard F.

AU - Menzies, Alexander M.

AU - Long, Georgina V.

AU - Ascierto, Paolo A.

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N2 - 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.

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Carlino MS, Vanella V, Girgis C, Giannarelli D, Guminski A, Festino L et al. Cessation of targeted therapy after a complete response in BRAF-mutant advanced melanoma: A case series. British Journal of Cancer. 2016 Nov 22;115(11):1280-1284. https://doi.org/10.1038/bjc.2016.321