Neoadjuvant BRAF‐targeted therapy in regionally advanced and oligometastatic melanoma
Current management of locoregional and oligometastatic melanoma is typically with surgery; however, some patients are unable to undergo resection due to location/size of their tumors and/or the anticipated morbidity of the surgery. While there are currently no established guidelines for neoadjuvant...
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| Veröffentlicht in: | Pigment cell and melanoma research 2020-01, Vol.33 (1), p.86-95 |
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| creator | Eroglu, Zeynep Eatrides, Jennifer Naqvi, Syeda Mahrukh Hussnain Kim, Youngchul Rich, Jeani Babacan, Nalan Akgul Brohl, Andrew S. Markowitz, Joseph Sarnaik, Amod Zager, Jonathan Khushalani, Nikhil I. Sondak, Vernon K. Messina, Jane |
| description | Current management of locoregional and oligometastatic melanoma is typically with surgery; however, some patients are unable to undergo resection due to location/size of their tumors and/or the anticipated morbidity of the surgery. While there are currently no established guidelines for neoadjuvant therapy in melanoma, neoadjuvant BRAF‐targeted therapy may make resection more feasible. A retrospective analysis was conducted of 23 patients with BRAFV600‐mutant, stage III/IV melanoma treated with BRAF‐targeted therapy prior to surgery, with no adjuvant treatment. Surgical specimens, preoperative imaging, and clinical outcomes were evaluated. Results: Ten of 23 patients (44%) attained a pathologic complete response (pCR), with no correlation between RECIST response based on preoperative imaging and pathologic response. After a median of 43‐month follow‐up, only 1 patient (10%) with a pCR recurred, while 8 of 13 (62%) patients without a pCR recurred. Patients with a pCR had significantly improved relapse‐free (RFS) and overall survival (OS) compared to patients with residual tumor. Neoadjuvant BRAF‐targeted therapy is associated with a high pCR rate in patients with stage III‐IV melanoma, which may correlate with improved RFS and OS. |
| doi_str_mv | 10.1111/pcmr.12813 |
| format | Article |
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While there are currently no established guidelines for neoadjuvant therapy in melanoma, neoadjuvant BRAF‐targeted therapy may make resection more feasible. A retrospective analysis was conducted of 23 patients with BRAFV600‐mutant, stage III/IV melanoma treated with BRAF‐targeted therapy prior to surgery, with no adjuvant treatment. Surgical specimens, preoperative imaging, and clinical outcomes were evaluated. Results: Ten of 23 patients (44%) attained a pathologic complete response (pCR), with no correlation between RECIST response based on preoperative imaging and pathologic response. After a median of 43‐month follow‐up, only 1 patient (10%) with a pCR recurred, while 8 of 13 (62%) patients without a pCR recurred. Patients with a pCR had significantly improved relapse‐free (RFS) and overall survival (OS) compared to patients with residual tumor. Neoadjuvant BRAF‐targeted therapy is associated with a high pCR rate in patients with stage III‐IV melanoma, which may correlate with improved RFS and OS.</description><identifier>ISSN: 1755-1471</identifier><identifier>EISSN: 1755-148X</identifier><identifier>DOI: 10.1111/pcmr.12813</identifier><identifier>PMID: 31329344</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Adult ; Aged ; BRAF‐targeted therapy ; Disease-Free Survival ; Female ; Humans ; Imidazoles - pharmacology ; Imidazoles - therapeutic use ; Male ; Melanoma ; Melanoma - diagnostic imaging ; Melanoma - pathology ; Melanoma - therapy ; Metastasis ; Middle Aged ; Molecular Targeted Therapy ; Morbidity ; Neoadjuvant Therapy ; Neoplasm Metastasis ; Neoplasm Staging ; Oximes - pharmacology ; Oximes - therapeutic use ; Patients ; Proto-Oncogene Proteins B-raf - antagonists & inhibitors ; Proto-Oncogene Proteins B-raf - metabolism ; Pyridones - pharmacology ; Pyridones - therapeutic use ; Pyrimidinones - pharmacology ; Pyrimidinones - therapeutic use ; Surgery ; Therapy ; Treatment Outcome ; Tumors</subject><ispartof>Pigment cell and melanoma research, 2020-01, Vol.33 (1), p.86-95</ispartof><rights>2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd</rights><rights>2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.</rights><rights>Copyright © 2020 John Wiley & Sons A/S</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4483-6901c2d4147122a0689f8c430edf331eb84bee84e87d25a77be841e4e953560e3</citedby><cites>FETCH-LOGICAL-c4483-6901c2d4147122a0689f8c430edf331eb84bee84e87d25a77be841e4e953560e3</cites><orcidid>0000-0002-2307-7030 ; 0000-0002-2530-2756</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fpcmr.12813$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fpcmr.12813$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>230,314,780,784,885,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31329344$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Eroglu, Zeynep</creatorcontrib><creatorcontrib>Eatrides, Jennifer</creatorcontrib><creatorcontrib>Naqvi, Syeda Mahrukh Hussnain</creatorcontrib><creatorcontrib>Kim, Youngchul</creatorcontrib><creatorcontrib>Rich, Jeani</creatorcontrib><creatorcontrib>Babacan, Nalan Akgul</creatorcontrib><creatorcontrib>Brohl, Andrew S.</creatorcontrib><creatorcontrib>Markowitz, Joseph</creatorcontrib><creatorcontrib>Sarnaik, Amod</creatorcontrib><creatorcontrib>Zager, Jonathan</creatorcontrib><creatorcontrib>Khushalani, Nikhil I.</creatorcontrib><creatorcontrib>Sondak, Vernon K.</creatorcontrib><creatorcontrib>Messina, Jane</creatorcontrib><title>Neoadjuvant BRAF‐targeted therapy in regionally advanced and oligometastatic melanoma</title><title>Pigment cell and melanoma research</title><addtitle>Pigment Cell Melanoma Res</addtitle><description>Current management of locoregional and oligometastatic melanoma is typically with surgery; however, some patients are unable to undergo resection due to location/size of their tumors and/or the anticipated morbidity of the surgery. While there are currently no established guidelines for neoadjuvant therapy in melanoma, neoadjuvant BRAF‐targeted therapy may make resection more feasible. A retrospective analysis was conducted of 23 patients with BRAFV600‐mutant, stage III/IV melanoma treated with BRAF‐targeted therapy prior to surgery, with no adjuvant treatment. Surgical specimens, preoperative imaging, and clinical outcomes were evaluated. Results: Ten of 23 patients (44%) attained a pathologic complete response (pCR), with no correlation between RECIST response based on preoperative imaging and pathologic response. After a median of 43‐month follow‐up, only 1 patient (10%) with a pCR recurred, while 8 of 13 (62%) patients without a pCR recurred. Patients with a pCR had significantly improved relapse‐free (RFS) and overall survival (OS) compared to patients with residual tumor. Neoadjuvant BRAF‐targeted therapy is associated with a high pCR rate in patients with stage III‐IV melanoma, which may correlate with improved RFS and OS.</description><subject>Adult</subject><subject>Aged</subject><subject>BRAF‐targeted therapy</subject><subject>Disease-Free Survival</subject><subject>Female</subject><subject>Humans</subject><subject>Imidazoles - pharmacology</subject><subject>Imidazoles - therapeutic use</subject><subject>Male</subject><subject>Melanoma</subject><subject>Melanoma - diagnostic imaging</subject><subject>Melanoma - pathology</subject><subject>Melanoma - therapy</subject><subject>Metastasis</subject><subject>Middle Aged</subject><subject>Molecular Targeted Therapy</subject><subject>Morbidity</subject><subject>Neoadjuvant Therapy</subject><subject>Neoplasm Metastasis</subject><subject>Neoplasm Staging</subject><subject>Oximes - pharmacology</subject><subject>Oximes - therapeutic use</subject><subject>Patients</subject><subject>Proto-Oncogene Proteins B-raf - antagonists & inhibitors</subject><subject>Proto-Oncogene Proteins B-raf - metabolism</subject><subject>Pyridones - pharmacology</subject><subject>Pyridones - therapeutic use</subject><subject>Pyrimidinones - pharmacology</subject><subject>Pyrimidinones - therapeutic use</subject><subject>Surgery</subject><subject>Therapy</subject><subject>Treatment Outcome</subject><subject>Tumors</subject><issn>1755-1471</issn><issn>1755-148X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kc9uEzEQxi0Eon_ohQdAK3FBldL633q9F6QStQWpLaiigps18U5SR7vr1Pa2yq2P0Gfsk-A0JQIOzMVjzU-fvpmPkLeMHrBchwvbhQPGNRMvyDarynLEpP75ctNXbIvsxDinVNGyFq_JlmCC10LKbfLjAj008-EW-lR8ujw6ebx_SBBmmLAp0jUGWCwL1xcBZ8730LbLApoM2zyGvil862a-wwQxQXK26LCF3nfwhryaQhtx7_ndJVcnx9_Hn0dnX0-_jI_ORlZKLUaqpszyRq5Mcg5U6XqqrRQUm6kQDCdaThC1RF01vISqmuQPQ4l1KUpFUeySj2vdxTDpsLHYpwCtWQTXQVgaD878PendtZn5W6NqriXXWeDDs0DwNwPGZDoXLbZ5DfRDNJwrVlclUzKj7_9B534I-SiZyvdUipVCZWp_TdngYww43Zhh1KzyMqu8zFNeGX73p_0N-jugDLA1cOdaXP5Hynwbn1-uRX8B-QSiFw</recordid><startdate>202001</startdate><enddate>202001</enddate><creator>Eroglu, Zeynep</creator><creator>Eatrides, Jennifer</creator><creator>Naqvi, Syeda Mahrukh Hussnain</creator><creator>Kim, Youngchul</creator><creator>Rich, Jeani</creator><creator>Babacan, Nalan Akgul</creator><creator>Brohl, Andrew S.</creator><creator>Markowitz, Joseph</creator><creator>Sarnaik, Amod</creator><creator>Zager, Jonathan</creator><creator>Khushalani, Nikhil I.</creator><creator>Sondak, Vernon K.</creator><creator>Messina, Jane</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>7TO</scope><scope>8FD</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>P64</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-2307-7030</orcidid><orcidid>https://orcid.org/0000-0002-2530-2756</orcidid></search><sort><creationdate>202001</creationdate><title>Neoadjuvant BRAF‐targeted therapy in regionally advanced and oligometastatic melanoma</title><author>Eroglu, Zeynep ; 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however, some patients are unable to undergo resection due to location/size of their tumors and/or the anticipated morbidity of the surgery. While there are currently no established guidelines for neoadjuvant therapy in melanoma, neoadjuvant BRAF‐targeted therapy may make resection more feasible. A retrospective analysis was conducted of 23 patients with BRAFV600‐mutant, stage III/IV melanoma treated with BRAF‐targeted therapy prior to surgery, with no adjuvant treatment. Surgical specimens, preoperative imaging, and clinical outcomes were evaluated. Results: Ten of 23 patients (44%) attained a pathologic complete response (pCR), with no correlation between RECIST response based on preoperative imaging and pathologic response. After a median of 43‐month follow‐up, only 1 patient (10%) with a pCR recurred, while 8 of 13 (62%) patients without a pCR recurred. Patients with a pCR had significantly improved relapse‐free (RFS) and overall survival (OS) compared to patients with residual tumor. Neoadjuvant BRAF‐targeted therapy is associated with a high pCR rate in patients with stage III‐IV melanoma, which may correlate with improved RFS and OS.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>31329344</pmid><doi>10.1111/pcmr.12813</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-2307-7030</orcidid><orcidid>https://orcid.org/0000-0002-2530-2756</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Aged BRAF‐targeted therapy Disease-Free Survival Female Humans Imidazoles - pharmacology Imidazoles - therapeutic use Male Melanoma Melanoma - diagnostic imaging Melanoma - pathology Melanoma - therapy Metastasis Middle Aged Molecular Targeted Therapy Morbidity Neoadjuvant Therapy Neoplasm Metastasis Neoplasm Staging Oximes - pharmacology Oximes - therapeutic use Patients Proto-Oncogene Proteins B-raf - antagonists & inhibitors Proto-Oncogene Proteins B-raf - metabolism Pyridones - pharmacology Pyridones - therapeutic use Pyrimidinones - pharmacology Pyrimidinones - therapeutic use Surgery Therapy Treatment Outcome Tumors |
| title | Neoadjuvant BRAF‐targeted therapy in regionally advanced and oligometastatic melanoma |
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