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Targeted therapies for patients with advanced melanoma

Published: Wed 9 Mar 2016 03:40 PM
Targeted therapies for patients with advanced melanoma
BRAF inhibitors offer another option to extend lives
March 9, 2016: Targeted therapies called BRAF inhibitors may offer patients with BRAF V600 mutation-positive advanced melanoma the possibility of longer survival. However, PHARMAC has so far declined to fund them in New Zealand.
In addition to Keytruda® (pembrolizumab) which has been in the news recently, there are other effective targeted therapies registered in New Zealand for the treatment of advanced melanoma.
In New Zealand, about one third of patients with advanced melanoma have changes (mutations) in the BRAF V600 gene (protein).1 This is known as BRAF mutation-positive melanoma. BRAF is a protein that controls cell growth and division. In BRAF-positive melanomas, the mutated BRAF protein causes the cells to grow and divide too quickly.
BRAF inhibitors, such as Zelboraf® (vemurafenib) developed by Roche, target cells with the mutated BRAF protein and slow down the growth of the melanoma. A large clinical trial has shown that Zelboraf provides several important benefits compared with chemotherapy. They include improved response rates, an increase in the amount of time people live without their melanoma getting worse and most importantly, a significant increase in how long they live.2
It is important to note that Zelboraf is only for the treatment of patients with advanced melanoma who have the BRAF V600 mutation.3 There is a simple diagnostic test that will help determine if a patient’s melanoma cells have the BRAF mutation.
Dr Rosalie Fisher, Medical Oncologist and board member of Melanoma NZ says, “the standard of care for patients with BRAF-mutated melanoma is to use BRAF plus MEK inhibitors and immunotherapies in sequence. It is only in using multiple therapies with differing mechanisms of action that we will truly increase the survival of patients with advanced melanoma.”
PHARMAC needs to consider all available treatment options for advanced melanoma, in line with international guidelines.4
References
1. Eccles MR, et al. Oral Presentation at the NZSO Annual Meeting 2015
2. Chapman PB, Hauschild A, Robert C, et al. Improved survival with vemurafenib in melanoma with BRAF V600E mutation [supplementary appendix appears online]. N Engl J Med 2011; 364: 2507-2516. http://www.ncbi.nlm.nih.gov/pubmed/21639808.
3. Zelboraf Data Sheet. 7 January 2016. Available from: http://www.medsafe.govt.nz/profs/datasheet/z/zelboraftab.pdf
4. Dummer R, Hauschild A, Lindenblatt N, et al. Cutaneous melanoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of Oncology 2015; 26 (Supplement 5): v126–v132
ENDS

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