The discovery and development of binimetinib for the treatment of melanoma.

The discovery and development of binimetinib for the treatment of melanoma.
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双米替尼用于治疗黑色素瘤的发现和发展。

DOI:
10.1080/17460441.2020.1746265
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发表时间:
2020-07
影响因子:
6.3
通讯作者:
Cohen MS
Cohen MS
中科院分区:
医学2区
文献类型:
--
作者:
Tran B;Cohen MS

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比美替尼是一种选择性丝裂原激活蛋白激酶(MEK1/2)的非竞争性小分子抑制剂,最近于2018年被批准与恩可拉非尼联合治疗转移性黑色素瘤。关于该药物的临床前和临床试验数据表明,它对癌症,特别是具有BRAF和NRAS突变的黑色素瘤具有强大的疗效。作者回顾了导致FDA在2018年批准其用于转移性黑色素瘤的临床前以及临床1、2和3期试验数据。在BRAF突变的转移性黑色素瘤患者中,联合使用Enorafenib的3期数据显示,与单用Vemurafenib(7.3个月)相比,PFS(14.9个月)增加了一倍。与FDA批准的其他疗法(包括免疫疗法或vemurafenib)相比,目前还没有更长期的数据表明比尼美替尼治疗有任何持久的、完全的反应或总存活率的改善。对BRAF突变的转移性黑色素瘤患者的治疗方法应该个体化,比美替尼联合恩可拉非尼是一种合理的口服策略,具有合理的耐受性。治疗成本和反应持续时间应纳入讨论,作为整体医疗决策的一部分。
Binimetinib is an uncompetitive, small molecule inhibitor of selective mitogen-activated protein kinase (MEK1/2) and was recently approved in 2018 in combination with encorafenib for the treatment of metastatic melanomas. Preclinical and clinical trial data on the drug demonstrate its potent efficacy in cancers, especially melanomas with BRAF and NRAS mutations. The authors review the preclinical as well as clinical Phase 1, 2 and 3 trial data leading to its FDA approval in 2018 for metastatic melanoma. Phase 3 data in combination with encorafenib demonstrated double the PFS (14.9 months) compared to vemurafenib alone (7.3 months) in patients with BRAF-mutated metastatic melanoma. No longer-term data is available yet to demonstrate any durable complete responses to therapy with binimetinib or improvements in overall survival compared to other FDA approved therapies including immunotherapy or vemurafenib. Treatment approaches to patients with BRAF mutated metastatic melanoma should be individualized and binimetinib in combination with encorafenib is a reasonable oral strategy with a reasonably tolerated toxicity profile. Cost of treatment and durability of response should be incorporated into the discussion as part of the overall medical decision making.
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