Doctors discuss the effectiveness of different treatment combinations for patients with BRAF-mutated metastatic melanoma and brain metastases, highlighting that consideration of patient preferences is essential in making treatment decisions.
The panel concludes their discussion with a call for continued research and collaboration, emphasizing the need for more understanding of targeted therapies, monitoring tools like ctDNA, and ongoing development in the field of BRAF mutant melanoma treatment.
Experts discuss treatment of patients with BRAF-mutated melanoma and symptomatic brain metastases, detailing radiation therapy, corticosteroid use, and the choice between BRAF/MEK inhibitor therapy and immunotherapy.
For patients with BRAF-mutated melanoma with asymptomatic brain metastases, immunotherapy, particularly the combination of ipilimumab and nivolumab, is the preferred treatment option due to its effectiveness and durability, as supported by the seven-year follow-up data from the CHECKMATE 204 trial.
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.