Rechallenge of targeted therapy in metastatic melanoma

Abstract

Summary Rechallenge of targeted therapy in patients with BRAFV600‐mutated melanoma plays an important role, because of the prolonged overall survival of melanoma patients. Patients may be rechallenged after a drug‐free interval following adverse drug reactions, after radiation therapy or surgery, following disease progression on subsequent immunotherapy or chemotherapy, or after disease progression without interim therapeutic intervention. To date, only few data has been published on treatment outcomes associated with rechallenge. The articles published on this topic included a total of 238 patients. In general, it was shown that patients did respond to rechallenge, even if they had previously experienced disease progression on targeted therapy. Patient response varied from stable disease to partial response and even complete remission in some cases. Our analysis showed overall response rates to rechallenge of 47 %, with disease control rates of 67 %. While mean progression‐free survival was 6.4 months, this was shorter than after the first round of targeted therapy (mean progression‐free survival of 9.2 months). Rechallenge of targeted therapy offers another option in the management of melanoma patients who have received extensive prior treatment. In particular, it will be important to clarify whether the type of interim treatment has an impact on the response to rechallenge.

Posteriores reversibles Enzephalopathie‐Syndrom bei einem Melanompatienten unter Dabrafenib‐ und Trametinib‐Behandlung nach Immuntherapie

“…BRAF-und MEK-Inhibitoren können eine Verringerung der angiogenen Wachstumsfaktoren wie VEGF und proangiogener Zytokine induzieren [12][13][14]. Dies könnte die zahlreichen Fälle von PRES unter VEGF-Inhibitoren wie Bevacizumab erklären [15].…”

Simultaneous targeted therapy for metastatic melanoma and hepatitis C

“…Combined therapy of advanced melanoma with BRAF/MEK inhibitors leads to an improvement of overall survival [1][2][3][4][5][6]. In 2014, the combined HCV-NS5A/nucleotide polymerase inhibitor Harvoni ® was approved for the treatment of chronic hepatitis C and demonstrated to be highly effective in previously untreated patients [7].…”

Current State of Target Treatment in BRAF Mutated Melanoma

“…For this reason, another interesting approach in melanoma patients is the rechallenge with targeted therapies, despite data from randomized trials are lacking. In a recently published minireview ( Reschke et al, 2019 ), 238 patients from several retrospective and prospective trials were analyzed showing a disease control rate of 67%.…”