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 Antonio Ascierto

Research output: Contribution to journalArticle

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.British Journal of Cancer advance online publication 6 October 2016; doi:10.1038/bjc.2016.321 www.bjcancer.com.

Original languageEnglish
JournalBritish Journal of Cancer
DOIs
Publication statusAccepted/In press - Oct 6 2016

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

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

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 Antonio.

In: British Journal of Cancer, 06.10.2016.

Research output: Contribution to journalArticle

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. 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 Antonio. / Cessation of targeted therapy after a complete response in BRAF-mutant advanced melanoma : a case series. In: British Journal of Cancer. 2016.
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AU - Giannarelli, Diana

AU - Guminski, Alex

AU - Festino, Lucia

AU - Kefford, Richard F.

AU - Menzies, Alexander M.

AU - Long, Georgina V.

AU - Ascierto, Paolo Antonio

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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.British Journal of Cancer advance online publication 6 October 2016; doi:10.1038/bjc.2016.321 www.bjcancer.com.

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