Dr. Pecora on Key Efficacy Findings from the DREAMSEQ Trial in BRAF-Mutated Melanoma

Andrew L. Pecora, MD, professor of Medicine and Oncology, Georgetown University School of Medicine, associate dean, Technology and Innovation, Hackensack Meridian School of Medicine, discusses the key efficacy findings from the phase 3 DREAMSEQ trial (NCT02224781) in BRAF-mutated melanoma.

The DREAMSEQ trial evaluated initial treatment with ipilimumab (Yervoy) plus nivolumab (Opdivo) followed by dabrafenib (Tafinlar) and trametinib (Mekinist), or the converse sequence, in patients with BRAF-mutated melanoma.

Key efficacy data from the trial revealed that patients who received nivolumab/ipilimumab first experienced benefits in progression-free survival (PFS) and overall survival (OS), Pecora explains. Patients treated with nivolumab/ipilimumab first achieved a median PFS of 11.8 months and a 2-year OS rate of 71.8%, compared with a median PFS of 8.5 months and a 2-year OS rate of 51.5% for patients given dabrafenib/trametinib first. Notably, there was no difference in overall toxicity, Pecora adds.

Additionally, patients who did not respond to immunotherapy up-front achieved better outcomes when salvaged with dabrafenib/trametinib, Pecora continues. Patients who progressed on targeted therapy had less of a chance of responding to the nivolumab/ipilimumab combination, Pecora concludes.