Sequential immunotherapy and targeted therapy for metastatic BRAF V600 mutated melanoma: 4-year survival and biomarkers evaluation from the phase II SECOMBIT trial.


Journal

Nature communications
ISSN: 2041-1723
Titre abrégé: Nat Commun
Pays: England
ID NLM: 101528555

Informations de publication

Date de publication:
02 Jan 2024
Historique:
received: 15 05 2023
accepted: 14 12 2023
medline: 4 1 2024
pubmed: 4 1 2024
entrez: 3 1 2024
Statut: epublish

Résumé

No prospective data were available prior to 2021 to inform selection between combination BRAF and MEK inhibition versus dual blockade of programmed cell death protein-1 (PD-1) and cytotoxic T lymphocyte antigen-4 (CTLA-4) as first-line treatment options for BRAFV600-mutant melanoma. SECOMBIT (NCT02631447) was a randomized, three-arm, noncomparative phase II trial in which patients were randomized to one of two sequences with immunotherapy or targeted therapy first, with a third arm in which an 8-week induction course of targeted therapy followed by a planned switch to immunotherapy was the first treatment. BRAF/MEK inhibitors were encorafenib plus binimetinib and checkpoint inhibitors ipilimumab plus nivolumab. Primary outcome of overall survival was previously reported, demonstrating improved survival with immunotherapy administered until progression and followed by BRAF/MEK inhibition. Here we report 4-year survival outcomes, confirming long-term benefit with first-line immunotherapy. We also describe preliminary results of predefined biomarkers analyses that identify a trend toward improved 4-year overall survival and total progression-free survival in patients with loss-of-function mutations affecting JAK or low baseline levels of serum interferon gamma (IFNy). These long-term survival outcomes confirm immunotherapy as the preferred first-line treatment approach for most patients with BRAFV600-mutant metastatic melanoma, and the biomarker analyses are hypothesis-generating for future investigations of predictors of durable benefit with dual checkpoint blockade and targeted therapy.

Identifiants

pubmed: 38167503
doi: 10.1038/s41467-023-44475-6
pii: 10.1038/s41467-023-44475-6
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

146

Informations de copyright

© 2024. The Author(s).

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Auteurs

Paolo A Ascierto (PA)

Department of Melanoma, Cancer Immunotherapy and Development Therapeutics. I.N.T. IRCCS Fondazione "G. Pascale", Napoli, Italy. p.ascierto@istitutotumori.na.it.

Milena Casula (M)

Immuno-Oncology & Targeted Cancer Biotherapies, University of Sassari - Unit of Cancer Genetics, IRGB-CNR, 07100, Sassari, Italy.

Jenny Bulgarelli (J)

Immunotherapy, Cell Therapy Unit and Biobank Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy.

Marina Pisano (M)

Immuno-Oncology & Targeted Cancer Biotherapies, University of Sassari - Unit of Cancer Genetics, IRGB-CNR, 07100, Sassari, Italy.

Claudia Piccinini (C)

Immunotherapy, Cell Therapy Unit and Biobank Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy.

Luisa Piccin (L)

Melanoma Oncology Unit, Veneto Institute of Oncology IOV-IRCCS, Padova, Italy.

Antonio Cossu (A)

Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, Italy.

Mario Mandalà (M)

University of Perugia, Perugia, Italy.
Department of Oncology and Haematology, Papa Giovanni XXIII Cancer Center Hospital, Bergamo, Italy.

Pier Francesco Ferrucci (PF)

Biotherapy of Tumors Unit, Department of Experimental Oncology, European Institute of Oncology, IRCCS, Milan, Italy.

Massimo Guidoboni (M)

Immunotherapy, Cell Therapy Unit and Biobank Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy.

Piotr Rutkowski (P)

Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska Curie National Research Institute of Oncology, 02-781 -, Warsaw, Poland.

Virginia Ferraresi (V)

Department of Medical Oncology 1, IRCCS Regina Elena National Cancer Institute, Rome, Italy.

Ana Arance (A)

Department of Medical Oncology, Hospital Clínic Barcelona, 08036, Barcelona, Spain.

Michele Guida (M)

Rare Tumors and Melanoma Unit, IRCCS Istituto dei Tumori "Giovanni Paolo II", Bari, Italy.

Evaristo Maiello (E)

Oncology Unit, Foundation IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy.

Helen Gogas (H)

First Department of Medicine, National and Kapodistrian University of Athens, Athens, Greece.

Erika Richtig (E)

Department of Dermatology, Medical University of Graz, Graz, Austria.

Maria Teresa Fierro (MT)

Department of Medical Sciences, Dermatologic Clinic, University of Turin, Turin, Italy.

Celeste Lebbe (C)

Dermato-Oncology and CIC AP-HP Hôpital Saint Louis,Cancer Institute APHP. Nord-Université Paris Cite F-75010, Paris, INSERM U976, France.

Hildur Helgadottir (H)

Department of Oncology-Pathology, Karolinska Institutet and Karolinska University Hospital Solna, Stockholm, Sweden.

Paola Queirolo (P)

Skin Cancer Unit, IRCCS Ospedale Policlinico San Martino, Genova, Italy.
Division of melanoma Sarcoma and Rare Tumors, IRCCS European Institute of Oncology, Milan, Italy.

Francesco Spagnolo (F)

Skin Cancer Unit, IRCCS Ospedale Policlinico San Martino, Genova, Italy.

Marco Tucci (M)

Department of Interdisciplinary Medicine, Oncology Unit, University of Bari "Aldo Moro", Bari, Italy.

Michele Del Vecchio (M)

Unit of Melanoma Medical Oncology, Department of Medical Oncology and Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.

Maria Gonzales Cao (MG)

Department of Medical Oncology, University Hospital Dexeus, Barcelona, Spain.

Alessandro Marco Minisini (AM)

Academic Hospital "Santa Maria della Misericordia", Udine, Italy.

Sabino De Placido (S)

Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, Italy.

Miguel F Sanmamed (MF)

Department of Interdisciplinary Medicine, Oncology Unit, University of Bari "Aldo Moro", Bari, Italy.

Domenico Mallardo (D)

Department of Melanoma, Cancer Immunotherapy and Development Therapeutics. I.N.T. IRCCS Fondazione "G. Pascale", Napoli, Italy.

Miriam Paone (M)

Department of Melanoma, Cancer Immunotherapy and Development Therapeutics. I.N.T. IRCCS Fondazione "G. Pascale", Napoli, Italy.

Maria Grazia Vitale (MG)

Department of Melanoma, Cancer Immunotherapy and Development Therapeutics. I.N.T. IRCCS Fondazione "G. Pascale", Napoli, Italy.

Ignacio Melero (I)

Department of Immunology and Oncology, Clínica Universidad de Navarra, Pamplona, Spain.

Antonio M Grimaldi (AM)

Department of Melanoma, Cancer Immunotherapy and Development Therapeutics. I.N.T. IRCCS Fondazione "G. Pascale", Napoli, Italy.
Medical Oncology Unit, AORN San Pio, Benevento, Italy.

Diana Giannarelli (D)

Fondazione Policlinico Universitario A. Gemelli, IRCCS - Facility of Epidemiology and Biostatistics, Rome, Italy.

Reinhard Dummer (R)

Department of Dermatology, University and University Hospital Zurich, Zurich, Switzerland.

Vanna Chiarion Sileni (VC)

Melanoma Oncology Unit, Veneto Institute of Oncology IOV-IRCCS, Padova, Italy.

Giuseppe Palmieri (G)

Immuno-Oncology & Targeted Cancer Biotherapies, University of Sassari - Unit of Cancer Genetics, IRGB-CNR, 07100, Sassari, Italy.

Classifications MeSH