The 7-year follow-up data for encorafenib/binimetinib showing that around 21% of patients remained progression-free supports BRAF/MEK inhibition as a later treatment option after immunotherapy failure, but doctors are reluctant to stop BRAF/MEK inhibitors given lack of data, even in those patients doing well long-term on the medications with minimal toxicity.
Panelists discuss the potential benefits of rechallenging patients with BRAF-mutated metastatic melanoma with BRAF/MEK inhibitors after a break from treatment, especially for those who initially responded well, and emphasizing the success of this approach in some cases, while highlighting the importance of monitoring and utilizing ctDNA tracking for more informed decision-making.
Key opinion leaders explain that clinicians should warn patients with BRAF-mutated metastatic melanoma starting BRAF/MEK inhibitor therapy about short-term toxicities like fever, chills, and rash that can differ greatly from immunotherapy toxicities.
The panel explains which BRAF/MEK inhibitor combination therapy they each tend to turn to when treating a patient with BRAF-mutated metastatic melanoma.
Beyond symptoms, doctors consider the psychosocial factors impacting treatment access and adherence, like insurance coverage, cost, family support, and preexisting conditions, when deciding between immunotherapy and targeted therapy for patients with BRAF-mutated metastatic melanoma.