Association between baseline disease characteristics and relapse-free survival (RFS) in patients (pts) with BRAF V600-mutant resected stage III melanoma treated with adjuvant dabrafenib (D) + trametinib (T) or placebo (PBO).

Authors

null

Dirk Schadendorf

Department of Dermatology, University Hospital Essen, Essen, Germany

Dirk Schadendorf , Reinhard Dummer , Axel Hauschild , Mario Santinami , Victoria Atkinson , Mario Mandalà , Vanna Chiarion-Sileni , James M.G. Larkin , Marta Nyakas , Caroline Dutriaux , Andrew Mark Haydon , Laurent Mortier , Caroline Robert , Jacob Schachter , Christine-Elke Ortmann , Egbert De Jong , Eduard Gasal , Richard Kefford , John M. Kirkwood , Georgina V. Long

Organizations

Department of Dermatology, University Hospital Essen, Essen, Germany, University Hospital Zürich Skin Cancer Center, Zürich, Switzerland, University Hospital Schleswig-Holstein, Kiel, Germany, Fondazione Istituto Nazionale Tumori, Milan, Italy, Princess Alexandra Hospital, Gallipoli Medical Research Foundation, University of Queensland, Woolloongabba, Australia, Department of Oncology and Haematology, Papa Giovanni XXIII Cancer Center Hospital, Bergamo, Italy, Melanoma Oncology Unit, Veneto Institute of Oncology IOV-IRCCS, Padova, Italy, Royal Marsden NHS Foundation Trust, London, United Kingdom, Oslo University Hospital, Oslo, Norway, Centre Hospitalier Universitaire de Bordeaux, Hôpital Saint-André, Bordeaux, France, The Alfred Hospital, Melbourne, Australia, Université de Lille, INSERM U 1189, Lille, France, Institut Gustave Roussy and Paris-Sud University, Villejuif, France, Ella Lemelbaum Institute for Melanoma, Sheba Medical Center, Tel Hashomer, Ramat-Gan, Israel, Novartis Pharma AG, Basel, Switzerland, Novartis Pharmaceuticals Corporation, East Hanover, NJ, Macquarie University, Melanoma Institute Australia, Westmead Hospital, and The University of Sydney, Sydney, Australia, Melanoma Program, UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, PA, Melanoma Institute Australia, The University of Sydney, and Royal North Shore and Mater Hospitals, Sydney, Australia

Research Funding

Pharmaceutical/Biotech Company

Background: In the COMBI-AD trial (NCT01682083), 12 mo of adjuvant D+T led to significant improvement of RFS vs PBO (hazard ratio [HR], 0.47; P< .001) in pts with resected BRAF V600–mutant stage III melanoma; 3- and 4-year RFS rates were 59% and 54%, respectively. Previous results demonstrated consistent treatment benefit across baseline disease stage according to AJCC edition 7 or 8. Here, we further explored the association between baseline disease characteristics and RFS to identify pt subgroups likely to benefit from adjuvant treatment. Methods: Randomized pts with completely resected BRAF V600E/K–mutant stage III melanoma received 12 mo of adjuvant D (150 mg BID) + T (2 mg QD) or PBO. Within each subgroup, predictive value was explored using Kaplan-Meier analysis, and HRs were calculated using a Pike estimator. Results: Minimum follow-up was 40 mo for 870 enrolled pts (D+T, 438; PBO, 432). Kaplan-Meier analysis demonstrated treatment benefit across all subgroups analyzed. Assessment of RFS by extent of primary tumor (T stage) showed consistent benefit favoring D+T vs PBO (HR [95% CI]; T1, 0.42 [0.25-0.70]; T2, 0.51 [0.34-0.76]; T3, 0.55 [0.39-0.77]; T4, 0.42 [0.29-0.60]). HRs by nodal burden (N stage) also showed consistent treatment benefit (N1, 0.52 [95% CI, 0.37-0.72]; N2, 0.38 [95% CI, 0.28-0.53]; N3, 0.58 [95% CI, 0.41-0.83]). Substantial treatment benefit was observed in pts with baseline in-transit metastases (HR, 0.45 [95% CI, 0.24-0.82]) and those with no in-transit metastases detected at baseline (HR, 0.49 [95% CI, 0.40-0.60]). When RFS was assessed according to melanoma presentation, treatment benefit favoring D+T vs PBO was observed in pts with superficial spreading melanoma (HR, 0.48 [95% CI, 0.35-0.66]) and those with nodular melanoma (HR, 0.53 [95% CI, 0.37-0.75]). Conclusions: These results confirm earlier findings showing that treatment benefit with adjuvant D+T vs PBO is independent of baseline factors. Clinical trial information: NCT01682083

Disclaimer

This material on this page is ©2024 American Society of Clinical Oncology, all rights reserved. Licensing available upon request. For more information, please contact licensing@asco.org

Abstract Details

Meeting

2019 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Melanoma/Skin Cancers

Track

Melanoma/Skin Cancers

Sub Track

Local-Regional Disease

Clinical Trial Registration Number

NCT01682083

Citation

J Clin Oncol 37, 2019 (suppl; abstr 9582)

DOI

10.1200/JCO.2019.37.15_suppl.9582

Abstract #

9582

Poster Bd #

153

Abstract Disclosures