CNS melanoma

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Seema Nagpal, MD
Stanford University
Palo Alto, CA
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Elizabeth Buchbinder, MD
Dana-Farber Cancer Institute
Boston, MA

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3 regimens on this page
3 variants on this page

Note: these are CNS-specific regimens, please see the main melanoma page for other regimens.


Guidelines

EANO/ESMO

NCCN

All lines of therapy

Dabrafenib monotherapy

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Regimen

FDA-recommended dose
Study Evidence Efficacy
Long et al. 2012 (BREAK-MB) Phase II ORR: 31-39%

Chemotherapy

Continued indefinitely

References

  1. 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

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Regimen

FDA-recommended dose
Study Evidence Efficacy
Davies et al. 2017 (COMBI-MB) Phase II ORR: 44-59%

Chemotherapy

Continued indefinitely

References

  1. 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

21-day cycle for 4 cycles, followed by:

Immunotherapy, part 2

14-day cycles

References

  1. 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