- Algazi, Alain P;
- Othus, Megan;
- Daud, Adil I;
- Lo, Roger S;
- Mehnert, Janice M;
- Truong, Thach-Giao;
- Conry, Robert;
- Kendra, Kari;
- Doolittle, Gary C;
- Clark, Joseph I;
- Messino, Michael J;
- Moore, Dennis F;
- Lao, Christopher;
- Faller, Bryan A;
- Govindarajan, Rangaswamy;
- Harker-Murray, Amy;
- Dreisbach, Luke;
- Moon, James;
- Grossmann, Kenneth F;
- Ribas, Antoni
Preclinical modeling suggests that intermittent BRAF inhibitor therapy may delay acquired resistance when blocking oncogenic BRAFV600 in melanoma1,2. We conducted S1320, a randomized, open-label, phase 2 clinical trial (NCT02196181) evaluating whether intermittent dosing of the BRAF inhibitor dabrafenib and the MEK inhibitor trametinib improves progression-free survival in patients with metastatic and unresectable BRAFV600 melanoma. Patients were enrolled at 68 academic and community sites nationally. All patients received continuous dabrafenib and trametinib during an 8-week lead-in period, after which patients with non-progressing tumors were randomized to either continuous or intermittent dosing of both drugs on a 3-week-off, 5-week-on schedule. The trial has completed accrual and 206 patients with similar baseline characteristics were randomized 1:1 to the two study arms (105 to continuous dosing, 101 to intermittent dosing). Continuous dosing yielded a statistically significant improvement in post-randomization progression-free survival compared with intermittent dosing (median 9.0 months versus 5.5 months, P = 0.064, pre-specified two-sided α = 0.2). Therefore, contrary to the initial hypothesis, intermittent dosing did not improve progression-free survival in patients. There were no differences in the secondary outcomes, including overall survival and the overall incidence of treatment-associated toxicity, between the two groups.