BRAF-mutant melanoma management: a single center retrospective analysis of patients treated with sequential therapy

In treating patients with melanoma, the order in which therapy is administered, choosing between targeted therapy and immune checkpoint inhibition, has garnered growing interest.

We conducted a retrospective, real-world analysis of patients with advanced melanoma undergoing immunotherapy or targeted therapy as first-line at a single center.

A total of 88 patients diagnosed with melanoma were identified. At 7 years, in this cohort, 68.4% (95% CI: 55.9%-83.6%) of patients were alive. In all, 47 tumors harbored BRAF mutations; 10 patients who did not receive therapy were excluded from this subgroup. Of the 37 patients with a BRAF mutation, 29 received first-line targeted therapy and 8 received first-line immunotherapy. At 2 years, 28 (76%) patients were alive and 9 (24%) had died. Of the 28 survivors, 22 received first-line targeted therapy and 6 received first-line immunotherapy. In addition, 29 patients were administered a MEK inhibitor in first line. Of these, 66.4% (95% CI: 48.3-91.2) of patients were alive at 7 years.

There was no significant difference between survival and first-line immunotherapy or first-line targeted therapy. Additional studies are required to establish whether front-line immunotherapy is linked to more effective long-term disease control compared to first-line targeted therapy.