Do BRAF Inhibitors Improve Survival in Patients With BRAF V600E Mutant Melanoma

OBJECTIVE: The objective of this selective EBM review is to determine whether or not “Do BRAF inhibitors improve survival in patients with BRAF V600E mutant melanoma?” STUDY DESIGN: Review of primary literature sources that examined survival rates in BRAF V600E mutant melanoma patients receiving treatment with a BRAF inhibitor. DATA SOURCES: Two randomized controlled trials and one cohort study evaluating the use of BRAF inhibitors in patients with BRAF V600E mutant melanoma were found using OVID, Medline, and PubMed. OUTCOMES MEASURED: Overall survival and progression free survival were the outcomes measured to determine survival rates in patients with BRAF V600E mutant melanoma. RESULTS: Chapman et al demonstrates an overall survival rate of 84% for Vemurafenib (95% CI, 78-89) compared to 64% for Dacarbazine (95% CI, 56-73). Progression free survival was 5.3 months for Vemurafenib compared to 1.6 months for Dacarbazine. Sosman et al, a cohort study, demonstrates an overall survival rate of 58% (95% CI, 49-67) after 12 months. Progression free survival was 6.8 months (95% CI, 5.6-8.1). Hauschild et al demonstrates an overall survival rate of 57% for Dabrafenib compared to 22% for Dacarbazine. Progression free survival was 5.1 months for Dabrafenib compared to 2.7 months for Dacarbazine. CONCLUSIONS: All studies reported longer periods of progression free survival and an increase in overall response rates. This suggests that BRAF inhibitors improve survival in patients with V600E mutant melanoma.