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Frequent brain metastases during treatment with BRAF/MEK inhibitors: A retrospective single institutional study
Author(s) -
Nakamura Yoshiyuki,
Ishitsuka Yosuke,
Tanaka Ryota,
Okiyama Naoko,
Watanabe Rei,
Saito Akimasa,
Furuta Junichi,
Fujisawa Yasuhiro
Publication year - 2020
Publication title -
the journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.9
H-Index - 65
eISSN - 1346-8138
pISSN - 0385-2407
DOI - 10.1111/1346-8138.15479
Subject(s) - medicine , melanoma , mek inhibitor , adjuvant , oncology , antibody , stage (stratigraphy) , combination therapy , clinical trial , cancer research , immunology , mapk/erk pathway , paleontology , kinase , biology , microbiology and biotechnology
Recent clinical trials revealed that both immune checkpoint inhibitors (ICI) and BRAF/MEK inhibitors significantly prolonged survival in melanoma patients when used for both advanced stage disease and postoperative adjuvant therapy. Although BRAF/MEK inhibitors are associated with a higher objective response rate than ICI, most patients relapse during treatment. However, progression patterns during treatment with BRAF/MEK inhibitors have not been extensively investigated. Here, we retrospectively collected the data of melanoma patients initially treated with BRAF/MEK inhibitors or anti‐programmed death 1 (PD‐1) antibody monotherapy at the University of Tsukuba Hospital and compared their results. The χ 2 ‐test revealed that frequency of brain metastasis (BM) development was significantly higher in cases treated with BRAF/MEK inhibitors compared with those with anti‐PD‐1 antibody monotherapy. In addition, BM‐free survival in cases treated with BRAF/MEK inhibitors was significantly shorter than those treated with anti‐PD‐1 antibody monotherapy. Our results indicate that BM development during treatment with BRAF/MEK inhibitors may be more frequent than anti‐PD‐1 antibody monotherapy, even though the extracranial metastases are well controlled. Therefore, we recommend frequent brain examinations during treatment with BRAF/MEK inhibitors to detect BM at an early stage and to promptly administrate ICI with local radiation therapy.