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Sequential treatment with ipilimumab and BRAF inhibitors in patients with metastatic melanoma: data from the Italian cohort of the ipilimumab expanded access program.

Ascierto PA, Simeone E, Sileni VC, Vecchio MD, Marchetti P, Cappellini GC,Ridolfi R, de Rosa F, Cognetti F, Ferraresi V, Testori A, Queirolo P, BernengoMG, Guida M, Galli L, Mandalà M, Cimminiello C, Rinaldi G, Carnevale-Schianca F, Maio M.

Cancer Invest. 2014 Jan 31. [Epub ahead of print]


Of 93 patients with pretreated, BRAF(V600) mutation-positive advanced melanoma who received vemurafenib or dabrafenib before (n = 45) or after (n = 48) treatment with ipilimumab 3 mg/kg, median overall survival (mOS) from first treatment was 9.9 and 14.5 months, respectively. Among patients treated with a BRAF inhibitor first, mOS from the end of BRAF inhibition was 1.2 months for those who did not complete ipilimumab treatment as per protocol, compared with 12.7 months for those who did (p < .001). Prospective, randomized studies are required to determine the optimal sequencing of ipilimumab and BRAF inhibitors in patients with BRAF-mutated metastatic melanoma.