Updates have been made to the National Comprehensive Cancer Network's (NCCN) Clinical Practice Guidelines in Oncology. These updates were presented at the recent NCCN Annual Conference. The most important updates are outlined below for melanoma by Daniel G. Coit, MD, of Memorial Sloan Kettering Cancer Center by way of OncLive.
Dr. Coit writes that the NCCN guidelines for melanoma are both "mature and quite up to date." Still, the doctor adds:
"The recent update on systemic therapies includes the addition of the combination of dabrafenib plus trametinib as a treatment option for patients with advanced BRAF-mutated disease. The ultimate impact of this combination, in terms of improvement in overall survival, still needs to be demonstrated. This is the focus of two ongoing phase III clinical trials that will soon be reported. The long-term efficacy of this combination remains to be demonstrated.”
NCCN updates on melanoma include the following:
- The combination of the BRAF inhibitor dabrafenib (Tafinlar) and MEK inhibitor trametinib (Mekinist) has been added as a preferred systemic therapy option for advanced melanoma that is BRAF-mutation positive. The combination was approved by the FDA based on a phase I/II clinical trial demonstrating improvement in progression-free survival.
- Single-agent trametinib is not indicated for patients with BRAF mutated melanoma who have experienced progression following monotherapy with an oral BRAF inhibitor (either dabrafenib or vemurafenib [Zelboraf]).
- A nodal basin ultrasound prior to a sentinel lymph node biopsy (SLNB) should be considered for patients who have an equivocal regional lymph node physical exam.
- Results of the international MSLT-1 trial confirm the important role of SLNB in staging patients with localized disease, but confirmed no survival advantage in patients who have had SLNB.
Source: OncLive
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