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- Title
First-line BRAF/MEK inhibitors versus anti-PD-1 monotherapy in BRAF<sup>V600</sup>-mutant advanced melanoma patients: a propensity-matched survival analysis.
- Authors
van Breeschoten, Jesper; Wouters, Michel W. J. M.; Hilarius, Doranne L.; Haanen, John B.; Blank, Christian U.; Aarts, Maureen J. B.; van den Berkmortel, Franchette W. P. J.; de Groot, Jan-Willem B.; Hospers, Geke A. P.; Kapiteijn, Ellen; Piersma, Djura; van Rijn, Roos S.; Suijkerbuijk, Karijn P. M.; Blokx, Willeke A. M.; Tije, Bert-Jan J. ten; Veldt, Astrid A. M. van der; Vreugdenhil, Art; Boers-Sonderen, Marye J.; van den Eertwegh, Alfonsus J. M.
- Abstract
<bold>Background: </bold>Anti-PD-1 antibodies and BRAF/MEK inhibitors are the two main groups of systemic therapy in the treatment of BRAFV600-mutant advanced melanoma. Until now, data are inconclusive on which therapy to use as first-line treatment. The aim of this study was to use propensity score matching to compare first-line anti-PD-1 monotherapy vs. BRAF/MEK inhibitors in advanced BRAFV600-mutant melanoma patients.<bold>Methods: </bold>We selected patients diagnosed between 2014 and 2017 with advanced melanoma and a known BRAFV600-mutation treated with first-line BRAF/MEK inhibitors or anti-PD-1 antibodies, registered in the Dutch Melanoma Treatment Registry. Patients were matched based on their propensity scores using the nearest neighbour and the optimal matching method.<bold>Results: </bold>Between 2014 and 2017, a total of 330 and 254 advanced melanoma patients received BRAF/MEK inhibitors and anti-PD-1 monotherapy as first-line systemic therapy. In the matched cohort, patients receiving anti-PD-1 antibodies as a first-line treatment had a higher median and 2-year overall survival compared to patients treated with first-line BRAF/MEK inhibitors, 42.3 months (95% CI: 37.3-NE) vs. 19.8 months (95% CI: 16.7-24.3) and 65.4% (95% CI: 58.1-73.6) vs. 41.7% (95% CI: 34.2-51.0).<bold>Conclusions: </bold>Our data suggest that in the matched BRAFV600-mutant advanced melanoma patients, anti-PD-1 monotherapy is the preferred first-line treatment in patients with relatively favourable patient and tumour characteristics.
- Publication
British Journal of Cancer, 2021, Vol 124, Issue 7, p1222
- ISSN
0007-0920
- Publication type
journal article
- DOI
10.1038/s41416-020-01229-1