Analysis of survival at metastatic melanoma patients treated with vemurafenib: A three year single institution study

Abstract

Introduction: The introduction of BRAF inhibitor vemurafenib significantly improved overall survival (OS) in metastatic melanoma patients. Aim of the Study: The purpose of this study was to determine OS and progression free survival (PFS) in patients with advanced metastatic melanoma treated with vemurafenib in the Oncology Clinic, University Clinical Centre of the Republic of Srpska (UKC RS). The secondary goal is to determine the effect of elevated serum lactate dehydrogenase (LDH) on OS. Patients and Methods: We analysed patients that received vemurafenib in the April 2015. until March 2018. They had pathohistologically confrmed B-RAF positive metastatic melanoma. LDH values were measured at the start of the treatment. Results: A total of 16 patients were analyzed, with an average age of 53 years (37-78). A large number of patients at the start had multiple sites of metastases. Calculated OS in patients who received vemurafenib is 11.8 months (p=0,23), with standard deviation (SD) 9.18. The calculated PFS is 9.5, SD 7,57. OS in patients with normal LDH is 14.4 months, SD 10.73, and with elevated LDH is 8.4 months, SD 4.9 (p=0.079). Conclusion: Use of vemurafenib resulted in an improvement in PFS, with improved OS in patients with advanced BRAF-mutated melanoma. In patients with elevated LDH OS was reduced. This shows that LDH is a good prognostic marker and that we should do it routinely for all patients with melanoma. This study has indicated the need for new diagnostic and therapeutic options for melanoma in Republic of Srpska.

Keywords

• metastatic melanoma
• braf mutation
• vemurafenib