Miantenance with Mekinist – pro
Standard duration of Mekinist therapy has been studied in a retrospective study by Stege et al who found that that patients who have initially received at least 16 months of TT, and who did not have to discontinue TT due to PD or toxicity are more likely to obtain a long-term response. The observation that treatment cessation due to toxicity is associated with a short PFS further suggests that treatment discontinuation due to toxicity should be avoided and toxicity control should be considered an important element of BRAF/MEK-directed TT not least with respect to the patients’ quality of life. Stege also suggests that doing prospective studies may be clinically challenging because of the occurrence of disease progression has been found to significantly worsen a subsequent reinduction of treatment.
Lee et al found that risk of progression after cessation of targeted therapy is strongly associated with treatment duration.
Stege H, Haist M, Schultheis M, Fleischer MI, Mohr P, Meier F, Schadendorf D, Ugurel S, Livingstone E, Zimmer L, Herbst R, Pföhler C, Kähler K, Weichenthal M, Terheyden P, Nashan D, Debus D, Kaatz M, Ziller F, Haferkamp S, Forschner A, Leiter U, Kreuter A, Ulrich J, Kleemann J, Bradfisch F, Grabbe S, Loquai C. Discontinuation of BRAF/MEK-Directed Targeted Therapy after Complete Remission of Metastatic Melanoma-A Retrospective Multicenter ADOReg Study. Cancers (Basel). 2021 May 12;13(10):2312. doi: 10.3390/cancers13102312. PMID: 34065877; PMCID: PMC8151093.
Lee J, Ahmed T, Maurichi A, Di Guardo L, Stagno AM, Warburton L, Taylor AM, Livingstone E, Rehman S, Khattak A, Kahler KC, Vanella V, Atkinson V, Millward M, Schadendorf D, Johnson DB, Ascierto PA, Hauschild A, Lo SN, Long GV, Menzies AM, Carlino MS. BRAF inhibitor cessation prior to disease progression in metastatic melanoma: Long-term outcomes. Eur J Cancer. 2023 Jan;179:87-97. doi: 10.1016/j.ejca.2022.11.009. Epub 2022 Nov 12. PMID: 36509002.