Revision as of 17:36, 6 January 2020

Section editor
	Elizabeth Buchbinder, MD Dana-Farber Cancer Institute Boston, MA LinkedIn

Note: these are regimens tested in biomarker-specific populations, please see the main melanoma page for other regimens.

2 regimens on this page 2 variants on this page

Advanced or metastatic disease, TKI-naive

Binimetinib monotherapy

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Regimen

Study	Evidence	Comparator	Comparative Efficacy
Ascierto et al. 2013	Phase II
Dummer et al. 2017 (NEMO)	Phase III (E-switch-ooc)	Dacarbazine	Superior PFS

Chemotherapy

Binimetinib (Mektovi) 45 mg PO twice per day

Continued indefinitely

References

Ascierto PA, Schadendorf D, Berking C, Agarwala SS, van Herpen CM, Queirolo P, Blank CU, Hauschild A, Beck JT, St-Pierre A, Niazi F, Wandel S, Peters M, Zubel A, Dummer R. MEK162 for patients with advanced melanoma harbouring NRAS or Val600 BRAF mutations: a non-randomised, open-label phase 2 study. Lancet Oncol. 2013 Mar;14(3):249-56. Epub 2013 Feb 13. link to original article contains protocol PubMed
NEMO: Dummer R, Schadendorf D, Ascierto PA, Arance A, Dutriaux C, Di Giacomo AM, Rutkowski P, Del Vecchio M, Gutzmer R, Mandala M, Thomas L, Demidov L, Garbe C, Hogg D, Liszkay G, Queirolo P, Wasserman E, Ford J, Weill M, Sirulnik LA, Jehl V, Bozón V, Long GV, Flaherty K. Binimetinib versus dacarbazine in patients with advanced NRAS-mutant melanoma (NEMO): a multicentre, open-label, randomised, phase 3 trial. Lancet Oncol. 2017 Apr;18(4):435-445. Epub 2017 Mar 8. link to original article contains protocol PubMed

Dacarbazine monotherapy

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Regimen

Study	Evidence	Comparator	Comparative Efficacy
Dummer et al. 2017 (NEMO)	Phase III (C)	Binimetinib	Inferior PFS

Chemotherapy

Dacarbazine (DTIC) 1000 mg/m² IV once on day 1

21-day cycles

References

NEMO: Dummer R, Schadendorf D, Ascierto PA, Arance A, Dutriaux C, Di Giacomo AM, Rutkowski P, Del Vecchio M, Gutzmer R, Mandala M, Thomas L, Demidov L, Garbe C, Hogg D, Liszkay G, Queirolo P, Wasserman E, Ford J, Weill M, Sirulnik LA, Jehl V, Bozón V, Long GV, Flaherty K. Binimetinib versus dacarbazine in patients with advanced NRAS-mutant melanoma (NEMO): a multicentre, open-label, randomised, phase 3 trial. Lancet Oncol. 2017 Apr;18(4):435-445. Epub 2017 Mar 8. link to original article contains protocol PubMed

@@ Line 33: / Line 33: @@
 |[https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(17)30180-8/fulltext Dummer et al. 2017 (NEMO)]
 |style="background-color:#1a9851"|Phase III (E-switch-ooc)
-|[[Melanoma#Dacarbazine_monotherapy|Dacarbazine]]
+|[[#Dacarbazine_monotherapy|Dacarbazine]]
 |style="background-color:#1a9850"|Superior PFS
 |-
@@ Line 45: / Line 45: @@
 # Ascierto PA, Schadendorf D, Berking C, Agarwala SS, van Herpen CM, Queirolo P, Blank CU, Hauschild A, Beck JT, St-Pierre A, Niazi F, Wandel S, Peters M, Zubel A, Dummer R. MEK162 for patients with advanced melanoma harbouring NRAS or Val600 BRAF mutations: a non-randomised, open-label phase 2 study. Lancet Oncol. 2013 Mar;14(3):249-56. Epub 2013 Feb 13. [https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(13)70024-X/fulltext link to original article] '''contains protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/23414587 PubMed]
 # '''NEMO:''' Dummer R, Schadendorf D, Ascierto PA, Arance A, Dutriaux C, Di Giacomo AM, Rutkowski P, Del Vecchio M, Gutzmer R, Mandala M, Thomas L, Demidov L, Garbe C, Hogg D, Liszkay G, Queirolo P, Wasserman E, Ford J, Weill M, Sirulnik LA, Jehl V, Bozón V, Long GV, Flaherty K. Binimetinib versus dacarbazine in patients with advanced NRAS-mutant melanoma (NEMO): a multicentre, open-label, randomised, phase 3 trial. Lancet Oncol. 2017 Apr;18(4):435-445. Epub 2017 Mar 8. [https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(17)30180-8/fulltext link to original article] '''contains protocol'''  [https://www.ncbi.nlm.nih.gov/pubmed/28284557 PubMed]
+==Dacarbazine monotherapy {{#subobject:d3599b|Regimen=1}}==
+{| class="wikitable" style="float:right; margin-left: 5px;"
+|-
+|[[#top|back to top]]
+|}
+===Regimen {{#subobject:bede4c|Variant=1}}===
+{| class="wikitable" style="width: 100%; text-align:center;"
+!style="width: 25%"|Study
+!style="width: 25%"|[[Levels_of_Evidence#Evidence|Evidence]]
+!style="width: 25%"|Comparator
+!style="width: 25%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
+|-
+|[https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(17)30180-8/fulltext Dummer et al. 2017 (NEMO)]
+|style="background-color:#1a9851"|Phase III (C)
+|[[#Binimetinib_monotherapy|Binimetinib]]
+|style="background-color:#d73027"|Inferior PFS
+|-
+|}
+====Chemotherapy====
+*[[Dacarbazine (DTIC)]] 1000 mg/m<sup>2</sup> IV once on day 1
+'''21-day cycles'''
+===References===
+# '''NEMO:''' Dummer R, Schadendorf D, Ascierto PA, Arance A, Dutriaux C, Di Giacomo AM, Rutkowski P, Del Vecchio M, Gutzmer R, Mandala M, Thomas L, Demidov L, Garbe C, Hogg D, Liszkay G, Queirolo P, Wasserman E, Ford J, Weill M, Sirulnik LA, Jehl V, Bozón V, Long GV, Flaherty K. Binimetinib versus dacarbazine in patients with advanced NRAS-mutant melanoma (NEMO): a multicentre, open-label, randomised, phase 3 trial. Lancet Oncol. 2017 Apr;18(4):435-445. Epub 2017 Mar 8. [https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(17)30180-8/fulltext link to original article] '''contains protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/28284557 PubMed]
 [[Category:Melanoma regimens]]
 [[Category:Biomarker-specific pages]]
 [[Category:Skin cancers]]

Difference between revisions of "Melanoma, NRAS-mutated"

Revision as of 17:36, 6 January 2020

Contents

Advanced or metastatic disease, TKI-naive

Binimetinib monotherapy

Regimen

Chemotherapy

References

Dacarbazine monotherapy

Regimen

Chemotherapy

References

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