Journal Watch: our panel of experts highlight the most important research articles across the spectrum of topics relevant to the field of melanoma management.

Abstract

Hauschild A, Dummer R, Schadendorf D et al. Longer follow-up confirms relapse-free survival benefit with adjuvant dabrafenib plus trametinib in patients with resected BRAF V600-mutant Stage III melanoma. J. Clin. Oncol. 36(35), 3441–3449 (2018) This publication, an update of the COMBI-AD trial, provides the most mature data with extended follow-up in Stage III metastatic melanoma patients treated with immune checkpoint or targeted therapies in the adjuvant setting. The results of this study of Stage III BRAF V600 mutant metastatic melanoma continue to show relapse-free survival (RFS) benefit at 40 months of dabrafenib plus trametinib therapy over placebo with an absolute difference of almost 20% between the arms. The RFS benefit was also confirmed regardless of stage, clinical and pathological subgroups. For the first time, the somewhat controversial, Weibull mixture cure-rate analysis has been used in metastatic melanoma patients and showed estimated cure rates of 54% (treatment arm) versus 37% (placebo arm). Moving forward it will be interesting to compare these results with the results of immunotherapy and combinations therapy trials in the adjuvant and neoadjuvant setting to ascertain the optimal treatment protocol for BRAF-mutant metastatic melanoma patients. – Written by Robert V Rawson