COMBINATION OF VEMURAFENIB+KOBIMETINIB FUNDAMENTALLY CHANGES PROGNOSIS FOR METASTATIC MELANOMA


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Abstract

The review summarizes the results of key studies on the efficacy and safety of kobimetinib (Cotellik) and vemurafenib (Zelboraf), both in combination therapy and as monotherapy in patients with melanoma. In a key coBRIM study, previously untreated patients with IIIC or IV stage melanoma and the presence of BRAF V600 mutations have received combination therapy kobimetinib+vemurafenib or vemurafenib as monotherapy. Significant advantage of the combination of vemurafenib+kobimetinib was demonstrated: an increase in progression-free survival, overall survival, and objective response rate. Toxicity profile of combination kobimetinib+vemurafenib was acceptable and manageable. Thus, combination therapy of kobimetinib with vemurafenib has a high therapeutic potential and is a new standard of care for patients with metastatic melanoma with the presence of BRAF V600 mutations.

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About the authors

S. A Protsenko

FSBI “SRI of Oncology n.a. N.N. Petrov" of RMH

Email: s.protsenko@list.ru
MD, Head of the Department of Chemotherapy and Innovative Technologies St.-Petersburg

E. M Anokhina

FSBI “SRI of Oncology n.a. N.N. Petrov" of RMH

St.-Petersburg

A. V Novik

FSBI “SRI of Oncology n.a. N.N. Petrov" of RMH

St.-Petersburg

A. I Semenova

FSBI “SRI of Oncology n.a. N.N. Petrov" of RMH

St.-Petersburg

References

  1. ВОЗ, Информационный бюллетень № 305 от декабря 2009 г «Ультрафиолетовое излучение и здоровье детей».
  2. Каприн А.Д, Старинский В.В., Петрова Г.В. (редколлегия). Злокачественные новообразования в России в 2013 г. (заболеваемость и смертность), М., 2015. С. 14-19, 84, 133, 186.
  3. Мерабишвили В.М., Беляев А.М. Злокачественные заболевания в Северо-Западном округе России. Выпуск второй. СПб., 2015. С. 74-75.
  4. Демидов Л.В., Орлова К.В. Индивидуализация лекарственного лечения меланомы кожи. Практическая онкология. 2013;14(4):239.
  5. Проценко С.А. Таргетная терапия при меланоме, гастроинтестинальных стромальных опухолях, дерматофибросаркоме протуберанс. Практическая онкология. 2010;11(3):162.
  6. Glatz K. Molecular heterogeneity of malignant melanomas. Pathologe. 2007;l28(6):474-78.
  7. Dossett L.A., Kudchadkar R.R., Zager J.S. BRAF and MEK inhibition in melanoma. Expert Opin Drug Saf. 2015;14(4):559-70.
  8. Keating G.M. Vemurafenib. A Review in BRAFV600 Mutation-Positive Unresectable or Metastatic Melanoma. Drugs. Springer International Publishing Switzerland, 2016. doi: 10.1007/s40265-016-0562-7.
  9. Garnett M.J., Marais R. Guilty as charged: B-RAF is a human oncogene.Cancer Cell. 2004; 6:313-19.
  10. Wan PT, Garnett M.J., Roe S.M., Lee S., Niculescu-Duvaz D., Good V.M., Jones C.M., Marshall C.J., Springer C.J., Barford D., Marais R. Mechanism of activation of the RAF-ERK signaling pathway by oncogenic mutations of B-RAF Cell 2004;116:855-67.
  11. Bollag G, Hirth P., Tsai J., et al. Clinical efficacy of a RAF inhibitor needs broad target blockade in BRAF-mutant melanoma. Nature. 2010;467:596-99.
  12. Yang H., Higgins B., Kolinsky K., Packman K., Go Z, Iyer R., Kolis S., Zhao S., Lee R., Grippo J.F, Schostack K., Simcox M.E., Heimbrook D., Bollag G., Su F. RG7204 (PLX4032), a selective BRAFV600E inhibitor, displays potent antitumor activity in preclinical melanoma models. Cancer Res. 2010;70:5518-27.
  13. Heidorn S.J., Milagre C., Whittaker S., Nourry A., Niculescu-Duvas I., Dhomen N., Hussain J., Reis-Filho J.S., Springer C.J., Pritchard C., Marais R. Kinase-dead BRAF and oncogenic RAS cooperate to drive tumor progression through CRAF. Cell. 2010;140:209-21.
  14. Poulikakos P.I., Zhang C., Bollag G., Shokat K.M., Rosen N. RAF inhibitors transactivate RAF dimers and ERK signalling in cells with wild-type BRAF. Nature. 2010;464:427-30.
  15. Hatzivassiliou G., Song K., Yen I., Brandhuber B.J., Anderson D.J., Alvarado R., Ludlam M.J., Stokoe D., Gloor S.L., Vigers G., Morales T., Aliagas I., Liu B., Sideris S., Hoeflich K.P, Jaiswal B.S., Seshagiri S., Koeppen H., Belvin M., Friedman L.S., Malek S. RAF inhibitors prime wild-type RAF to activate the MAPK pathway and enhance growth. Nature. 2010;464:431-35.
  16. Spagnolo F., Ghiorzo P., Queirolo P. Overcoming resistance to BRAF inhibition in BRAF-mutated metastatic melanoma. Oncotarget. 2014;5(21):10206-21.
  17. McArthur G.A., Chapman P.B., Robert C., et al. Safety and efficacy of vemurafenib in BRAFV600E and BRAFV600K mutation-positive melanoma (BRIM-3): extended follow-up of a phase 3, randomised, open-label study. Lancet Oncol. 2014;5(3):323-32.
  18. Chapman PB., Robert C., Larkin J. Vemurafenib (VEM) in Patients (Pts) With BRAFV600 Mutation-Positive Metastatic Melanoma (MM): Final Overall Survival (OS) Results of the BRIM-3 Stud. SMR. 2015.
  19. Atkinson V., Larkin J., McArthur G., et al. Improved overall survival (OS) with cobimetinib (COBI) vemurafenib (V) in advanced BRAF-mutated melanoma and biomarker correlates of efficacy [abstract]. In: Society for Melanoma Research 2015 Congress. 2015.
  20. Wongchenko M., McArthur G.A., Andries L., et al. Gene expression profiling reveals distinct subpopulations of BRAF-mutant melanoma patients each with different outcomes when treated with vemurafenib or combined vemurafenib and cobimetinib [abstract]. Pigment Cell Melanoma Res. 2015;28(6):823.
  21. Trunzer K., Pavlick A.C., Schuchter L., et al. Pharmacodynamic effects and mechanisms of resistance to vemurafenib in patients with metastatic melanoma. J Clin Oncol. 2013;31(14):1767-74.
  22. European Medicines Agency. Cotellic (cobimetinib): EU summary of product characteristics. 2015. http://ec.europa.eu. Accessed 2 Feb 2016.
  23. European Medicines Agency. Zelboraf (vemurafenib) film-coated tablets: EU summary of product characteristics. 2015. http://www. ema.europa.eu. Accessed 2 Feb 2016.
  24. Genentech USA Inc. Cotellic (cobimetinib) tablets, for oral use: US prescribing information. 2015. http://www.gene.com. Accessed 2 Feb 2016.
  25. Han K., Jin J., Marchand M., Eppler S., Choong N., HackS.P, Tikoo N., Bruno R., Dresser M., Musib L., Budha N.R. Population pharmacokinetics and dosing implications for cobimetinib in patients with solid tumors. Cancer Chemother Pharmacol. 2015;76(5):917-24.
  26. Genentech USA Inc. Zelboraf (vemurafenib) tablet for oral use: US prescribing information. 2015. http://www.gene.com. Accessed 2 Feb 2016.
  27. Ribas A., Gonzalez R., Pavlick A., Hamid O., Gajewski T.F., Daud A., Flaherty L., Logan T., Chmielowski B., Lewis K., Kee D., Boasberg P., Yin M., Chan I., Musib L., Choong N., Puzanov I., McArthur G.A. Combination of vemurafenib and cobimetinib in patients with advanced BRAFV600-mutated melanoma: a phase 1b study. Lancet Oncol. 2014;15(9):954-65.
  28. Larkin J., Ascierto P.A., Dreno B., Atkinson V., Liszkay G., Maio M., Mandala M., Demidov L., Stroyakovskiy D., Thomas L., de la Cruz-Merino L., Dutriaux C., Garbe C., Sovak M.A., Chang I., Choong N., Hack S.P., McArthur G.A., Ribas A. Combined vemurafenib and cobimetinib in BRAF-mutated melanoma. N. Engl. J. Med. 2014;371(20):1867-76.
  29. Pavlick A.C., Ribas A., Gonzalez R., et al. Extended follow-up results of phase Ib study (BRIM7) of vemurafenib (VEM) with cobimetinib (COBI) in BRAF-mutant melanoma [abstract no.9020]. J. Clin. Oncol. 2015;33(Suppl).
  30. Larkin J.M.G., Yan Y., McArthur G.A., et al. Update of progression free survival (PFS) and correlative biomarker analysis from coBRIM: phase III study of cobimetinib (cobi) plus vemurafenib (vem) in advanced BRAF-mutated melanoma. [abstract no. 9006]. J Clin Oncol. 2015;33(15 Suppl 1).
  31. McArthur G.A., et al. Eur. J. Cancer. 2015;51:S720-S723.
  32. Dreno B., Ribas A., Larkin J., et al. Incidence, course, and management of toxicities associated with vemurafenib and cobimetinib in the coBRIM study [abstract plus poster]// In: Society for Melanoma Research 2014 Congress. 2014.
  33. De La Cruz-Merino L., Di Guardo L., Grob J-J., et al. Clinical features of cobimetinib (COBI)-associated serous retinopathy (SR) in BRAF-mutated melanoma patients (pts) treated in the coBRIM study [abstract no. 9033 plus poster]. J. Clin. Oncol. 2015;33(15 Suppl 1).
  34. Larkin J., Del Vecchio M., Ascierto PA., et al. Vemurafenib in patients with BRAFV600 mutated metastatic melanoma: an openlabel, multicentre, safety study. Lancet Oncol.2014;15(4):436-44.
  35. Das Thakur M., Salangsang F., Landman A.S., Sellers W.R., Pryer N.K., Levesque M.P, Dummer R., McMahon M., Stuart D.D. Modelling vemurafenib resistance in melanoma reveals a strategy to forestall drug resistance. Nature. 2013;494(7436):251-56.
  36. Moriceau G., Hugo W., Hong A., et al. Tunable-combinatorial mechanisms of acquired resistance limit the efficacy of BRAF/MEK cotargeting but result in melanoma drug addiction. Cancer Cell. 2015;27(2):240-56.
  37. Sullivan R., LoRusso P., Boerner S., Dummer R. Achievements and challenges of molecular targeted therapy in melanoma. Am. Soc. Clin. Oncol. Educ. Book. 2015:177-86.
  38. Dummer R., Goldinger S.M., Turtschi C.P, et al. Vemurafenib in patients with BRAFV600 mutation-positive melanoma with symptomatic brain metastases: final results of an open-label pilot study. Eur. J. Cancer. 2014;50(3):611-21.
  39. Yee M.K., Lin Y., Gorantla V.C., et al. Phase 2 study of cobimetinib in combination with vemurafenib in active melanoma brain metastases (coBRIM-B) [abstract no. TPS9088 plus poster]. J. Clin. Oncol. 2015;33(15 Suppl 1).
  40. Su F., Viros A., Milagre C., et al. RAS mutations in cutaneous squamous-cell carcinomas in patients treated with BRAF inhibitors. N. Engl. J. Med. 2012;366(3):207-15.
  41. Anforth R., Carlos G., Clements A., et al. Cutaneous adverse events in patients treated with BRAF inhibitor-based therapies for metastatic melanoma for longer than 52 weeks. Br. J. Dermatol. 2015;172(1):239-43.
  42. Dummer R., Hauschild A., Lindenblatt N., Pentheroudakis G., Keilholz U. Cutaneous melanoma: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2015;26(Suppl 5):v126-32.
  43. National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: melanoma (version 2.2016). 2015. http:// www.nccn.org. Accessed 2 Feb 2016.

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