학술논문

PD-L1 blockade in combination with inhibition of MAPK oncogenic signaling in patients with advanced melanoma.
Document Type
article
Source
Nature communications. 11(1)
Subject
Humans
Melanoma
Skin Neoplasms
Exanthema
Diarrhea
Oximes
Imidazoles
Pyridones
Pyrimidinones
Proto-Oncogene Proteins B-raf
Mitogen-Activated Protein Kinases
Antineoplastic Combined Chemotherapy Protocols
Antibodies
Monoclonal
Cohort Studies
Mutation
Adult
Aged
Aged
80 and over
Middle Aged
Female
Male
Young Adult
B7-H1 Antigen
Progression-Free Survival
Language
Abstract
Combining PD-L1 blockade with inhibition of oncogenic mitogen-activated protein kinase (MAPK) signaling may result in long-lasting responses in patients with advanced melanoma. This phase 1, open-label, dose-escalation and -expansion study (NCT02027961) investigated safety, tolerability and preliminary efficacy of durvalumab (anti-PD-L1) combined with dabrafenib (BRAF inhibitor) and trametinib (MEK inhibitor) for patients with BRAF-mutated melanoma (cohort A, n = 26), or durvalumab and trametinib given concomitantly (cohort B, n = 20) or sequentially (cohort C, n = 22) for patients with BRAF-wild type melanoma. Adverse events and treatment discontinuation rates were more common than previously reported for these agents given as monotherapy. Objective responses were observed in 69.2% (cohort A), 20.0% (cohort B) and 31.8% (cohort C) of patients, with evidence of improved tumor immune infiltration and durable responses in a subset of patients with available biopsy samples. In conclusion, combined MAPK inhibition and anti-PD-L1 therapy may provide treatment options for patients with advanced melanoma.