Difference between revisions of "CNS melanoma"
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Warner-admin (talk | contribs) m (Text replacement - "{| class="wikitable" style="width: 100%; text-align:center;" !style="width: 33%"|Study !style="width: 33%"|Evidence !style="width: 33%"|Efficacy" to "{| class="wikitable" style="width: 75%; text-align:center;" !style="width: 33%"|Study !style="width: 33%"|Evidence !style="width: 33%"|Efficacy") |
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*[[Dabrafenib (Tafinlar)]] 150 mg PO twice per day | *[[Dabrafenib (Tafinlar)]] 150 mg PO twice per day | ||
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===References=== | ===References=== | ||
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*[[Trametinib (Mekinist)]] 2 mg PO once per day | *[[Trametinib (Mekinist)]] 2 mg PO once per day | ||
| − | '''Continued | + | '''Continued indefinitely''' |
===References=== | ===References=== | ||
Revision as of 18:52, 12 July 2019
| Section editors | |||
|---|---|---|---|
 |
Seema Nagpal, MD Stanford University Palo Alto, CA |
 |
Elizabeth Buchbinder, MD Dana-Farber Cancer Institute Boston, MA |
5 regimens on this page
5 variants on this page
|
Note: these are CNS-specific regimens, please see the main melanoma page for other regimens.
Guidelines
EANO/ESMO
- 2017: Le Rhun et al. EANO–ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up of patients with leptomeningeal metastasis from solid tumours
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 twice per day
Continued indefinitely
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
Dabrafenib & Trametinib
| back to top |
Regimen
| FDA-recommended dose |
| Study | Evidence | Efficacy |
|---|---|---|
| Davies et al. 2017 (COMBI-MB) | Phase II | ORR: 44-59% |
Chemotherapy
- Dabrafenib (Tafinlar) 150 mg PO twice per day
- Trametinib (Mekinist) 2 mg PO once per day
Continued indefinitely
References
- COMBI-MB: Davies MA, Saiag P, Robert C, Grob JJ, Flaherty KT, Arance A, Chiarion-Sileni V, Thomas L, Lesimple T, Mortier L, Moschos SJ, Hogg D, Márquez-Rodas I, Del Vecchio M, Lebbé C, Meyer N, Zhang Y, Huang Y, Mookerjee B, Long GV. Dabrafenib plus trametinib in patients with BRAF(V600)-mutant melanoma brain metastases (COMBI-MB): a multicentre, multicohort, open-label, phase 2 trial. Lancet Oncol. 2017 Jul;18(7):863-873. Epub 2017 Jun 4. link to original article contains protocol PubMed
Ipilimumab & Nivolumab
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Regimen
| Study | Evidence | Comparator |
|---|---|---|
| Long et al. 2018 (ANZMTG 01.14) | Randomized Phase II (E) | 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