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Trainee Oral Presentation Session Abstracts
Author(s) -
Matthew Chan,
Lauren E. Haydu,
Alexander M. Menzies,
Mary Azer,
Oliver Klein,
Megan Lyle,
Arthur Clements,
Alex Guminski,
Richard Kefford,
Georgina V. Long
Publication year - 2013
Publication title -
asia‐pacific journal of clinical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.73
H-Index - 29
eISSN - 1743-7563
pISSN - 1743-7555
DOI - 10.1111/ajco.12106
Subject(s) - session (web analytics) , presentation (obstetrics) , citation , library science , convention , medical education , computer science , medicine , world wide web , political science , surgery , law
Background: There is accelerated tumour growth on BRAFi cessation in BRAFi-resistant melanoma cell lines. BRAFi-treated pts have high initial response rates but progress at 6+ months. The benefit of BRAFi after RECIST-defined disease progression (PD) is unknown. We examined pts treated beyond progression (TBP) versus those not TBP, and whether TBP prolongs survival. Methods: Clinicopathologic data at baseline and PD were collected for 112 pts with unresectable stage IIIC/IV BRAF-mutant melanoma treated with dabrafenib or vemurafenib in phase I-IV trials at Westmead Hospital and the Melanoma Institute Australia from July 2009–September 2012. TBP = ongoing BRAFi >28 days beyond PD. Results: 92/114 (81%) pts had PD. 36/92 (39%) patients were TBP (mean 144 days, median 93 days, range 29–572 days). Patient’s TBP were more likely to; achieve CR/PR prior to PD, have a lower ECOG at PD, brain metastases at PD, have PD treated locally and smaller RECIST sum of diameters (SoD) at PD, compared with those not TBP (all p < 0.05). Median OS from commencement of BRAFi in those TBP was longer than those not TBP (17.8 versus 7 months, p < 0.001), as was overall survival (OS) from PD (7.7 versus 2.0 mo, p = 0.001). In multivariate analysis, TBP improved OS from PD (HR 0.47, 95% CI 0.24–0.905 p = 0.024) even after adjusting for potential prognostic factors at PD (SoD at PD).Within the TBP cohort, RECIST SoD at PD was the only factor that influenced OS from PD (p = 0.018). Conclusions: BRAFi may be continued after PD in selected pts, and is associated with prolonged OS compared with stopping at PD.1 page(s