John Theurer Cancer Center at Hackensack University Medical Center Shares Key Efficacy Findings from the DREAMseq Trial in BRAF-Mutated Melanoma

Patients who received nivolumab/ipilimumab before followed by dabrafenib (Tafinlar) and trametinib (Mekinist) experienced benefits in progression-free survival

Andrew L. Pecora, M.D., professor of Medicine and Oncology, Georgetown University School of Medicine, associate dean, Technology and Innovation, Hackensack Meridian School of Medicine, recently co-authored the Phase 3 DREAMseq trial 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 findings include:

• Patients who received nivolumab/ipilimumab first experienced benefits in progression-free survival and overall survival.
• Data showed no difference in overall toxicity.
• Patients who did not respond to immunotherapy up front achieved better outcomes when salvaged with dabrafenib/trametinib. 
• Those who progressed on targeted therapy had less of a chance of responding to the nivolumab/ipilimumab combination.

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. 

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