Sequencing of immunotherapy and targeted therapy for BRAFV600 mutated melanoma: a retrospective study

Abstract

With the increased number of therapy options for advanced melanoma, a personalized treatment strategy is of great importance. Currently, patients with a BRAFV600 mutation can receive first-line therapy with PD-1 (programmed cell death protein 1) inhibitors, a combination of PD-1 and CTLA4 (cytotoxic T-lymphocyte-associated protein 4) inhibitors, or targeted therapy (TT) consisting of BRAF and MEK inhibitors [1]. The lack of randomized clinical trials and biomarker studies that analyze the optimal therapeutic sequence for patients with BRAFV600 mutated patients makes the choice of a first-line therapy difficult. One retrospective study showed a longer overall survival for patients who received PD-1 inhibitors as first-line therapy than for patients who received targeted therapy [2]. However, other studies suggest that PD-1 inhibitors and targeted therapies are equally effective, regardless of the treatment sequence [3, 4]. We retrospectively analyzed patients with an advanced BRAFV600 mutated melanoma who had received PD-1 inhibitors, a combination of PD-1 and CTLA4 inhibitors or targeted therapy with BRAF and MEK inhibitors at the Clinical Letter