Overall survival in COMBI-d, a randomized, double-blinded, phase III study comparing the combination of dabrafenib and trametinib with dabrafenib and placebo as first-line therapy in patients (pts) with unresectable or metastatic BRAF V600E/K mutation-positive cutaneous melanoma.

Authors

Georgina Long

Georgina V. Long

Melanoma Institute Australia and The University of Sydney, North Sydney, Australia

Georgina V. Long , Daniil Stroyakovskiy , Helen Gogas , Evgeny Levchenko , Filippo G. De Braud , James M. G. Larkin , Claus Garbe , Thomas Jouary , Axel Hauschild , Jean Jacques Grob , Vanna Chiarion-Sileni , Celeste Lebbe , Mario Mandalà , Michael Millward , Douglas James DeMarini , Jhangir G Irani , Fan Jin , R. Suzanne Swann , Bijoyesh Mookerjee , Keith Flaherty

Organizations

Melanoma Institute Australia and The University of Sydney, North Sydney, Australia, Moscow City Oncology Hospital #62, Chemotherapy Department, Moscow, Russia, 1st Department of Medicine, Medical School, University of Athens, Athens, Greece, Petrov Research Institute of Oncology, Saint Petersburg, Russia, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy, The Royal Marsden NHS Foundation Trust, London, United Kingdom, University of Tübingen, Tübingen, Germany, Hôpital François Mitterrand, Pau, France, University of Kiel, Kiel, Germany, Aix-Marseille University, Hopital de la Timone, Marseille, France, Veneto Oncology Institute, Padova, Italy, Dermatology Department, Hôpital Saint-Louis, Assistance-Publique-Hôpitaux de Paris, Paris, France, Papa Giovanni XXIII Hospital, Bergamo, Italy, Sir Charles Gairdner Hospital, Perth, Australia, GlaxoSmithKline, Collegeville, PA, Massachusetts General Hospital and Dana-Farber Cancer Institute, Boston, MA

Research Funding

Pharmaceutical/Biotech Company

Background: This phase III study (NCT01584648) of dabrafenib (D) + trametinib (T) compared with D + placebo (P) demonstrated superior progression-free survival (PFS) for D+T compared with D+P (HR = 0.75 ; 95% CI: 0.57–0.99; p = 0.035) in pts with BRAF V600E/K mutant, metastatic melanoma at the primary analysis (N Engl J Med 2014;371:1877). The interim overall survival (OS) favored D+T (40 deaths on D+T vs 55 on D+P), but did not cross the pre-planned stopping boundary for efficacy. Median time on study at the primary analysis was 9 months (0–16 months). Rates of adverse events (AEs) were similar for both arms. More pts had AEs leading to dose modifications with D+T vs D+P, and fewer hyperproliferative skin AEs were reported with D+T. The study was continued after the primary analysis to evaluate OS without crossover from D+P to D+T. Methods: Pts were randomized 1:1 to receive D (150mg twice daily) + T (2mg once daily) or D+P as first-line therapy. Eligible pts were age 18 or older, ECOG performance status ≤ 1, and had histologically confirmed unresectable stage IIIC or IV, BRAF V600E/K mutant cutaneous melanoma. The primary endpoint was investigator-assessed PFS; secondary endpoints were OS, overall response rate (ORR), duration of response (DoR), and safety. The final statistical OS comparison was to be initiated when 220 events were reported. Results: From May 2012 to January 2013, 423 pts were randomized (211 to D+T, 212 to D+P). The 220th death was reported on Jan 12, 2015; analysis is expected to be completed in Mar 2015. Estimated median time on study at data cut off is 20 months (0-31 months). Conclusions: The statistical analysis will evaluate the superiority of D+T vs D+P for OS. A 2-year OS landmark analysis, updated PFS, ORR, DoR, and safety will be presented. Clinical trial information: NCT01584648

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Abstract Details

Meeting

2015 ASCO Annual Meeting

Session Type

Clinical Science Symposium

Session Title

Targeted Therapies: Does the Disease Still Matter?

Track

Special Sessions

Sub Track

Melanoma/Skin Cancers

Clinical Trial Registration Number

NCT01584648

Citation

J Clin Oncol 33, 2015 (suppl; abstr 102)

DOI

10.1200/jco.2015.33.15_suppl.102

Abstract #

102

Abstract Disclosures