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Updated: Jul 1, 2025
Spatial and Temporal Control of Murine Melanoma Initiation from Mutant Melanocyte Stem Cells
Published on: June 7, 2019
Targeted therapy or immunotherapy in BRAF-mutated metastatic melanoma: a Spanish center's decade of experience
Chen Sun1, Sofia España2, Nina Richarz3
1Department of Radiation Oncology, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Background:
Targeted therapies and immunotherapy are currently considered the mainstay first-line treatment for advanced BRAF-mutated melanoma. However, the impact of treatment (targeted therapy and immunotherapy) and the prognostic factors are still not clear.
Material And Methods:
Medical records of 140 patients diagnosed with advanced melanoma between 2011 and 2021 were retrospectively reviewed to extract demographic, BRAF status, treatment, performance status, and survival data. ORR, PFS, and OS were compared between patients diagnosed with advanced melanoma and treated with first-line IT or BRAF/MEKi. The prognostic factors were assessed using Cox regression models.
Results:
In all patients and those treated with immunotherapy, we did not find any effect of BRAF status on ORR, PFS, or OS. In patients with BRAF-mutated melanoma, ORR was 43.8% vs. 70% (P=0.04), PFS was 19.2 vs. 11.5 months (p=0.22), and OS was 33.4 vs. 16.4 months for the immunotherapy and targeted therapy groups, respectively (P=0.04). ECOG, presence of brain metastases, and high LDH level from initiation of first-line treatment were all associated with differences in PFS and OS.
Conclusion:
Patients with advanced BRAF-mutated melanoma treated with first-line immunotherapy had a significantly longer PFS and OS than those treated with first-line BRAF/MEKi; however, first-line BRAF/MEKi treatment had a significantly higher ORR than first-line immunotherapy.
Insights
For advanced BRAF-mutated melanoma, first-line immunotherapy significantly improved progression-free survival (PFS) and overall survival (OS) compared to targeted therapy (BRAF/MEKi). Targeted therapy showed a higher objective response rate (ORR).
Area of Science:
- Oncology
- Melanoma Research
- Cancer Therapeutics
Background:
- Advanced BRAF-mutated melanoma treatment primarily relies on targeted therapies and immunotherapy.
- The comparative impact of these first-line treatments and key prognostic factors remains incompletely understood.
Purpose of the Study:
- To evaluate the effectiveness of first-line immunotherapy versus targeted therapy (BRAF/MEKi) in advanced BRAF-mutated melanoma.
- To identify prognostic factors influencing survival outcomes in this patient population.
Main Methods:
- Retrospective review of 140 advanced melanoma patient records (2011-2021).
- Comparison of objective response rate (ORR), progression-free survival (PFS), and overall survival (OS) between immunotherapy and BRAF/MEKi groups.
- Prognostic factor assessment using Cox regression models.
Main Results:
- In BRAF-mutated melanoma, immunotherapy yielded significantly longer PFS (19.2 months) and OS (33.4 months) versus targeted therapy (PFS: 11.5 months, OS: 16.4 months).
- Targeted therapy demonstrated a higher ORR (70%) compared to immunotherapy (43.8%).
- ECOG performance status, brain metastases, and elevated LDH levels were significant prognostic factors for PFS and OS.
Conclusions:
- First-line immunotherapy offers superior PFS and OS benefits over targeted BRAF/MEKi therapy in advanced BRAF-mutated melanoma.
- While targeted therapy achieves higher initial response rates, immunotherapy demonstrates better long-term survival outcomes.
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