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Neoadjuvant BRAF‐targeted therapy in regionally advanced and oligometastatic melanoma
Author(s) -
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 Ver K.,
Messina Jane
Publication year - 2020
Publication title -
pigment cell and melanoma research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.618
H-Index - 105
eISSN - 1755-148X
pISSN - 1755-1471
DOI - 10.1111/pcmr.12813
Subject(s) - medicine , melanoma , neoadjuvant therapy , targeted therapy , oncology , stage (stratigraphy) , adjuvant therapy , complete response , retrospective cohort study , adjuvant , surgery , cancer , chemotherapy , cancer research , breast cancer , paleontology , biology
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.