Vemurafenib in Chinese patients with BRAF mutation-positive unresectable or metastatic melanoma: an open-label, multicenter phase I study.

Lu Si, Xiaoshi Zhang, Zhen Xu, Qiudi Jiang, Lilian Bu, Xuan Wang, Lili Mao, Weijiang Zhang, Nicole Richie, Jun Guo

Journal: BMC cancer 2019;18(1):520

PMID: 29724167

Abstract

BACKGROUND

Melanoma is a rare, deadly disease without effective treatment options in China. Vemurafenib is a selective inhibitor of oncogenic BRAF kinase approved in more than 90 countries, based on results obtained primarily in Caucasian patients. Limited data are available regarding the efficacy and safety of vemurafenib in Asian patients.

METHODS

This phase I study investigated the pharmacokinetics, efficacy, and tolerability of vemurafenib (960 mg twice daily) in Chinese patients with BRAF mutation-positive unresectable or metastatic melanoma. The study included two cohorts: a pharmacokinetic cohort (n = 20) and an expansion cohort (n = 26).

RESULTS

After 21 days of dosing, vemurafenib demonstrated marked accumulation and relatively constant steady-state exposure over the dosing period. Confirmed best overall response rate was 52.2% (95% CI 37.0-67.1%). Median progression-free survival was 8.3 months (95% CI 5.7-10.9%); median overall survival was 13.5 months (95% CI 12.2%-not estimable). The most common adverse events were dermatitis acneiform, arthralgia, diarrhea, blood cholesterol level increase, blood bilirubin level increase, melanocytic nevus, and alopecia. A total of nine grade 3 or 4 adverse events were reported in seven patients (15.2%).

CONCLUSION

Overall, vemurafenib showed a favorable benefit-risk profile among Chinese patients. Pharmacokinetics, safety, and efficacy were generally consistent with those reported in Caucasian patients.

TRIAL REGISTRATION

ClinicalTrials.gov identification: NCT01910181 . Registered 29 July 2013, prospectively registered.

Address: Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital & Institute, 52# Fucheng Road, Haidian District, Beijing, 100142, China.; Sun Yat-sen University Cancer Center, 651 Dongfeng R. E, Guangzhou, 510060, China.; Roche Product Development in Asia Pacific, 1100 Longdong Ave, Pudong District, Shanghai, 201203, China.; Roche R&D Center China Ltd., 917 Ha Lei Road, Building 6, Pudong District, Shanghai, 201203, China.; Roche Innovation Center New York, 430 E. 29th Street, New York, NY, 10016, USA.; Genentech, Inc., 1000 National Ave 231, San Bruno, California, 94066, USA.; Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital & Institute, 52# Fucheng Road, Haidian District, Beijing, 100142, China. [email protected].
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