A retrospective observational study of patients with melanoma prescribed combined BRAF and MEK inhibitors in a real-world treatment setting in Japan

Abstract

Objective: This study aimed to describe patients with melanoma initiating treatments with dabrafenib plus trametinib (Dab + Tram) or encorafenib plus binimetinib (Enco + Bini) in a real-world setting in Japan.

Methods: Data were extracted from the Japanese Medical Data Vision (MDV) insurance claims database. Patients diagnosed with melanoma between 2012 and 2021 and prescribed with Dab + Tram or Enco + Bini were included in three cohorts: non-adjuvant Dab + Tram, adjuvant Dab + Tram, and Enco + Bini. Data were extracted on patient characteristics at treatment initiation. During follow-up, all changes in melanoma treatments were documented. Treatment adherence was determined as the proportion of prescription days covered (PDC) and treatment dose intensity as the relative dose intensity (RDI).

Results: Sixty-seven patients were included in the non-adjuvant Dab + Tram cohort (55 first-line treatments), seven in the adjuvant Dab + Tram cohort (six first-line treatments), and 16 in the Enco + Bini cohort (four first-line treatments). The mean age was 61.3 ± 13.5 years and 56.1% were men. Twenty-seven patients with non-adjuvant Dab + Tram or Enco + Bini in first line (45.8%) switched to a second line. The median treatment duration was 11.8 months for Dab + Tram and 8.1 months for Enco + Bini. A PDC ≥ 80% was observed for 85.7% of patients with adjuvant Dab + Tram, 68.7% for non-adjuvant Dab + Tram, and 75.0% for Enco + Bini. Median RDI was 1.0 for adjuvant Dab + Tram, 0.9 for non-adjuvant Dab + Tram, and 0.6 for Enco + Bini.

Conclusion: Dab + Tram is used consistently with clinical practice guide-lines in the adjuvant setting, but adherence in the non-adjuvant setting is suboptimal, as is the prescribed dose of Enco + Bini. Prescribers should ensure that these therapies are used in an optimal way to improve outcomes in melanoma.

Keywords

BRAF / medication use / MEK / melanoma / targeted kinase inhibitor

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