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Currently, there are many approved treatment options for patients with BRAF mutations in unresectable or metastatic melanoma (MM), and there are effective diagnostic tools to assess BRAF mutation status
.
A study published today in Cancer Treat Rev aims to conduct a systematic literature review (SLR) of trials investigating the efficacy and safety of all currently available treatment options in patients with BRAF-mutant MM, and to use Bayesian network element analysis (NMA) to compare
the relative efficacy and safety of targeted therapies.
The researchers systematically searched the Medline, Embase, and Cochrane databases for relevant studies up to November
2020.
Pre-defined inclusion criteria
were used for selection.
Bayesian NMA
was performed after a reversal assessment of the included studies.
As a result, a total of 43 publications reporting on 15 targeted therapy trials and 42 publications reporting on 18 immunotherapy trials were retained from SLR and considered for NMA
.
Due to the large amount of interstudy heterogeneity in immunotherapy trials, the analysis concluded that the network was limited to targeted therapies
.
In combination therapy, ennofenib + bimetinib was superior to dabrafenib + trametinib (OR = 1.
86; 95% confidence interval [CrI] 1.
10, 3.
17) in terms of overall response rate, and better than vemurafenib + cobitinib (OR = 0.
51;95% CrI 0.
29, 0.
91) and fewer withdrawals due to AEs (OR = 0.
45; 95% CrI 0.
21, 0.
96), and superior to altekazolimab + vemurafenib + cobitinib (OR = 0.
41; 95% CrI 0.
21, 0.
82)
in less SAE.
The efficacy endpoints of atezolizumab + vemurafenib + cobitinib and ennofenib + bimetinib were basically similar
.
In dual therapy, ennofenib + birutinib was better
at all efficacy and safety endpoints.
Taken together, the NMA confirmed that combination therapy is more effective
than monotherapy.
Enoxenib + bimetinib has good efficacy compared to other dual therapies and has a good safety profile
compared to dual and triple therapy.
Original source:
Pippa Corrie, et al.
,Comparative efficacy and safety of targeted therapies for BRAF-mutant unresectable or metastatic melanoma: Results from a systematic literature review and a network meta-analysis.
Cancer Treat Rev.
2022 Nov; 110:102463.
doi: 10.
1016/j.
ctrv.
2022.
102463.
