Dabrafenib/trametinib bests docetaxel for advanced NSCLC in indirect comparison

AT A SYMPOSIUM IN THORACIC ONCOLOGY

CHICAGO (FRONTLINE MEDICAL NEWS) – Compared with docetaxel in matched external controls, combination therapy with dabrafenib and trametinib was associated with significantly prolonged progression-free and overall survival in previously treated patients with metastatic non–small cell lung cancer in a phase 2 trial.

Median progression-free survival (PFS) was 9.7 months in 57 patients in an open-label, multicenter phase 2 trial that investigated dabrafenib/trametinib treatment for metastatic BRAF V600E–mutated NSCLC, compared with 4.2 months in 290 patients treated with docetaxel in the randomized phase 3 CheckMate057 trial, which compared nivolumab and docetaxel in similar patients (hazard ratio, 0.32). Overall survival in the groups was 19.2 vs. 9.3 months, respectively (HR, 0.41), Junlong Li, MD, of Analysis Group, Boston, reported at the Chicago Multidisciplinary Symposium in Thoracic Oncology.

Patients treated with the combination of dabrafenib and trametinib also had a significantly higher overall response rate (61% vs. 12%) and disease control rate (77% vs. 55%), Dr. Li said.

Patient-level data for the combination therapy patients and summary data for the docetaxel-treated patients were used for the current analysis. Patients and controls were matched based on age, sex, race, smoking history, performance score, tumor histology, prior regimens, prior radiotherapy, and prior maintenance therapy. The two trials used for the analysis ( NCT01336634 and CheckMate 057 ) were comparable in design and inclusion/exclusion criteria, and both used RECIST v1.1 to evaluate response to therapy.

“In the absence of head-to-head trials … this study contributes some comparative efficacy evidence in this area,” Dr. Li concluded.

Invited discussant, Thomas Eldridge Stinchcombe, MD , of Duke University, Durham, N.C., said that the findings are unsurprising but important in that they are confirmatory.

Dr. Li is a consultant for Novartis, which sponsored the analysis.

sworcester@frontlinemedcom.com

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