Difference between revisions of "CNS melanoma"
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=All lines of therapy= | =All lines of therapy= | ||
| + | ==Dabrafenib monotherapy {{#subobject:8f3562|Regimen=1}}== | ||
| + | {| class="wikitable" style="float:right; margin-left: 5px;" | ||
| + | |- | ||
| + | |[[#top|back to top]] | ||
| + | |} | ||
| + | ===Regimen {{#subobject:fa5aa0|Variant=1}}=== | ||
| + | {| class="wikitable" style="color:white; background-color:#404040" | ||
| + | |<small>'''FDA-recommended dose'''</small> | ||
| + | |- | ||
| + | |} | ||
| + | {| class="wikitable" style="width: 100%; text-align:center;" | ||
| + | !Study | ||
| + | ![[Levels_of_Evidence#Evidence|Evidence]] | ||
| + | ![[Levels_of_Evidence#Efficacy|Efficacy]] | ||
| + | |- | ||
| + | |[http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(12)70431-X/fulltext Long et al. 2012 (BREAK-MB)] | ||
| + | |style="background-color:#91cf61"|Phase II | ||
| + | | style="background-color:#8c6bb1" |ORR: 31-39% | ||
| + | |- | ||
| + | |} | ||
| + | ====Chemotherapy==== | ||
| + | *[[Dabrafenib (Tafinlar)]] 150 mg PO BID | ||
| + | |||
| + | '''Given until progression of disease''' | ||
| + | |||
| + | ===References=== | ||
| + | # '''BREAK-MB:''' Long GV, Trefzer U, Davies MA, Kefford RF, Ascierto PA, Chapman PB, Puzanov I, Hauschild A, Robert C, Algazi A, Mortier L, Tawbi H, Wilhelm T, Zimmer L, Switzky J, Swann S, Martin AM, Guckert M, Goodman V, Streit M, Kirkwood JM, Schadendorf D. Dabrafenib in patients with Val600Glu or Val600Lys BRAF-mutant melanoma metastatic to the brain (BREAK-MB): a multicentre, open-label, phase 2 trial. Lancet Oncol. 2012 Nov;13(11):1087-95. Epub 2012 Oct 8. [http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(12)70431-X/fulltext link to original article] '''contains verified protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/23051966 PubMed] | ||
| + | |||
==Ipilimumab & Nivolumab {{#subobject:28103f|Regimen=1}}== | ==Ipilimumab & Nivolumab {{#subobject:28103f|Regimen=1}}== | ||
{| class="wikitable" style="float:right; margin-left: 5px;" | {| class="wikitable" style="float:right; margin-left: 5px;" | ||
Revision as of 12:41, 7 May 2018
| Section editors | |||
|---|---|---|---|
 |
Seema Nagpal, MD Palo Alto, CA |
 |
Elizabeth Buchbinder, MD Boston, MA |
5 regimens on this page
5 variants on this page
|
Guidelines
NCCN
All lines of therapy
Dabrafenib monotherapy
| back to top |
Regimen
| FDA-recommended dose |
| Study | Evidence | Efficacy |
|---|---|---|
| Long et al. 2012 (BREAK-MB) | Phase II | ORR: 31-39% |
Chemotherapy
- Dabrafenib (Tafinlar) 150 mg PO BID
Given until progression of disease
References
- BREAK-MB: Long GV, Trefzer U, Davies MA, Kefford RF, Ascierto PA, Chapman PB, Puzanov I, Hauschild A, Robert C, Algazi A, Mortier L, Tawbi H, Wilhelm T, Zimmer L, Switzky J, Swann S, Martin AM, Guckert M, Goodman V, Streit M, Kirkwood JM, Schadendorf D. Dabrafenib in patients with Val600Glu or Val600Lys BRAF-mutant melanoma metastatic to the brain (BREAK-MB): a multicentre, open-label, phase 2 trial. Lancet Oncol. 2012 Nov;13(11):1087-95. Epub 2012 Oct 8. link to original article contains verified protocol PubMed
Ipilimumab & Nivolumab
| back to top |
Regimen
| Study | Evidence | Comparator |
|---|---|---|
| Long et al. 2018 (ANZMTG 01.14) | Randomized Phase II | Nivolumab |
Immunotherapy, part 1
- Ipilimumab (Yervoy) 3 mg/kg IV once on day 1
- Nivolumab (Opdivo) 1 mg/kg IV once on day 1
21-day cycle for 4 cycles, followed by:
Immunotherapy, part 2
- Nivolumab (Opdivo) 3 mg/kg IV over 60 minutes once on day 1
14-day cycles
References
- ANZMTG 01.14: Long GV, Atkinson V, Lo S, Sandhu S, Guminski AD, Brown MP, Wilmott JS, Edwards J, Gonzalez M, Scolyer RA, Menzies AM, McArthur GA. Combination nivolumab and ipilimumab or nivolumab alone in melanoma brain metastases: a multicentre randomised phase 2 study. Lancet Oncol. 2018 Mar 27. link to original article contains verified protocol PubMed