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The impact of BRAF mutation status on clinical outcomes with anti‐PD‐1 monotherapy versus combination ipilimumab/nivolumab in treatment‐naïve advanced stage melanoma
Author(s) -
Ma Vincent T.,
DaignaultNewton Stephanie,
Waninger Jessica J.,
Journey Sara,
Chopra Zoey,
Tezel Alangoya,
Redman Bruce G.,
Fecher Leslie A.,
Green Michael D.,
Alva Ajjai S.,
Lao Christopher D.
Publication year - 2021
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.12944
Subject(s) - nivolumab , ipilimumab , medicine , oncology , pembrolizumab , cohort , melanoma , regimen , combination therapy , univariate analysis , vemurafenib , progression free survival , metastatic melanoma , immunotherapy , cancer , overall survival , multivariate analysis , cancer research
Nearly half of all metastatic melanoma patients possess the BRAF V600 mutation. Several therapies are approved for advanced stage melanoma, but it is unclear if there is a differential outcome to various immunotherapy regimens based on BRAF mutation status. We retrospectively analyzed a cohort of metastatic or unresectable melanoma patients who were treated with combination ipilimumab/nivolumab (ipi/nivo) or anti‐PD‐1 monotherapy, nivolumab, or pembrolizumab, as first‐line treatment. 235 previously untreated patients were identified in our study. Our univariate analysis showed no statistical difference in progression‐free survival (PFS) or overall survival (OS) with ipi/nivo versus anti‐PD‐1 monotherapy in the BRAF V600 mutant cohort, but there was improved PFS [HR: 0.48, 95% CI, 0.28–0.80] and OS [HR: 0.50, 95% CI, 0.26–0.96] with ipi/nivo compared to anti‐PD‐1 monotherapy in the BRAF WT group. After adjusting for known prognostic variables in our multivariable analysis, the BRAF WT cohort continued to show PFS and OS benefit with ipi/nivo compared to anti‐PD‐1 monotherapy. Our single‐institution analysis suggests ipi/nivo should be considered over anti‐PD‐1 monotherapy as the initial immunotherapy regimen for metastatic melanoma patients regardless of BRAF mutation status, but possibly with greater benefit in BRAF WT.