The implication of first-line therapy in BRAF mutant melanoma
melanoma
DISEASE PROGRESSION, MELANOMA
Two randomized studies, SECOMBIT and DREAMseq, investigated the optimal first-line treatment in patients with BRAF-mutant unresectable melanoma.SECOMBIT is a phase 2 study, in which patients were randomized to receive first-line encorafenib/binimetinib (BRAF inhibitor, MEK inhibitor) followed by ipilimumab/nivolumab upon disease progression (arm A), first line ipilimumab/nivolumab followed by encorafenib/binimetinib upon disease progression (arm B) and to “sandwich” arm, where 8-week induction phase with encorafenib/binimetinib was followed by a treatment switch to ipilimumab/nivolumab until disease progression and then back to encorafenib/binimetinib upon further progress (arm C) [Another study to have investigated the treatment sequence in patients with BRAF-mutant unresectable melanoma was DREAMseq. In this phase III study, treatment-naive patients were randomized to receive either upfront IT with ipilimumab/nivolumab (arm A) or upfront TT with dabrafenib/trametinib (arm B) with crossover to the alternate therapy at disease progression [