Adviezen commissie BOM

Terug naar lijst Medische Oncologie nummer 1, pp. 32-34
feb 2016, jaargang 18

Behandeling van het gemetastaseerd melanoom anno 2016

De afgelopen 5 jaar hebben zich revolutionaire veranderingen in de behandeling van het gemetastaseerd melanoom voorgedaan. Kort nadat een optimale plaatsbepaling was vastgesteld voor BRAF-remmers en ipilimumab, zijn recentelijk MEK-remmers (cobimetinib en trametinib) en anti-PD-1-antilichamen (nivolumab en pembrolizumab) ter beschikking gekomen. De vraag is: hoe kunnen deze nieuwe (uiterst kostbare) medicijnen het best worden ingezet?

Literatuur

  • Atkinson V, Larkin J, McArthur G, et al. Improved overall survival with cobimetinib and vemurafenib in advanced BRAFV600-mutated melanoma and biomarker correlates of efficacy. Abstract Society for Melanoma Research 2015 Congress.
  • Kang SP et al. Relationship between pembrolizumab exposure and efficacy/safety in 1016 patients with advanced or metastatic melanoma. Abstract #3344 European Cancer Congress 2015.
  • Kelderman S, Heemskerk B, van Tinteren H, et al. Lactate dehydrogenase as a selection criterion for ipilimumab treatment in metastatic melanoma. Cancer Immunol Immunother 2014;63(5):449-58.
  • Larkin J, Ascierto PA, Dréno B, et al. Combined vemurafenib and cobimetinib in BRAF-mutated melanoma. N Engl J Med 2014 13;371(20):1867-76.
  • Larkin J, Chiarion-Sileni V, Gonzalez R, et al. Combined nivolumab and ipilimumab or monotherapy in untreated melanoma. N Engl J Med 2015 2;373(1):23- 34.
  • Long GV, Stroyakovskiy D, Gogas H, et al. Combined BRAF and MEK inhibition versus BRAF inhibition alone in melanoma. N Engl J Med 2014 13;371(20):1877-88.
  • Long GV, Stroyakovskiy D, Gogas H, et al. Dabrafenib and trametinib versus dabrafenib and placebo for Val600 BRAF-mutant melanoma: a multicentre, double-blind, phase 3 randomised controlled trial. Lancet 2015 1;386(9992):444-51.
  • Long GV, Grob JJ, Davies M, et al. Baseline and postbaseline characteristics associated with treatment benefit across dabrafenib and trametinib registration pooled data. Abstract Society for Melanoma Research 2015 Congress.
  • Ribas A, Puzanov I, Dummer R, et al. Pembrolizumab versus investigator-choice chemotherapy for ipilimumab-refractory melanoma (KEYNOTE-002): a randomised, controlled, phase 2 trial. Lancet Oncol 2015;16(8):908-18.
  • Robert C, Schachter J, Long GV, et al; KEYNOTE-006 investigators. Pembrolizumab versus ipilimumab in advanced melanoma. N Engl J Med 2015 25;372(26):2521-32.
  • Robert C, Karaszewska B, Schachter J, et al. Improved overall survival in melanoma with combined dabrafenib and trametinib. N Engl J Med 2015;372(1):30-9.
  • Robert C, Long GV, Brady B, et al. Nivolumab in previously untreated melanoma without BRAF mutation. N Engl J Med 2015;372(4):320-30.
  • Robert C, Karaszewska B, Schachter J, et al. Two year estimate of overall survival in COMBI-v, a randomized, open-label, phase III study comparing the combination of dabrafenib (D) and trametinib (T) with vemurafenib (Vem) as first-line therapy in patients (pts) with unresectable or metastatic BRAF V600E/K mutation-positive cutaneous melanoma. Abstract #3301 European Cancer Congress 2015.
  • Schadendorf D, Hodi FS, Robert C, et al. Pooled analysis of long-term survival data from phase II and phase III trials of ipilimumab in unresectable or metastatic melanoma. J Clin Oncol. 2015;33(17):1889-94.