Dr. Flaherty Discusses the COLUMBUS Trial in Melanoma

Keith T. Flaherty, MD, director, Termeer Center for Targeted Therapy, Massachusetts General Hospital Cancer Center, professor of medicine, Harvard Medical School, discusses the COLUMBUS trial in patients with BRAF-mutant melanoma.

This trial investigated the BRAF inhibitor encorafenib alone or in combination with the MEK inhibitor binimetinib, versus vemurafenib (Zelboraf). The median progression-free survival (PFS) observed for the combination of encorafenib and binimetinib was just shy of 15 months. The PFS was a few months longer than other combinations have demonstrated to date, says Flaherty. The response rate, however, was similar between encorafenib and binimetinib and other BRAF/MEK combinations.

One of the striking features, says Flaherty, was that overall survival (OS) was markedly longer than seen with any of the previous BRAF/MEK combinations. The median OS was just over 33 months. PFS and OS were proportionally longer compared to recently established standard therapies, says Flaherty.

A major point of caution is that physicians did not directly compare the new BRAF/MEK combination to old BRAF/MEK combinations. The internal control of encorafenib versus vemurafenib showed the superiority of encorafenib which adds credibility to the combination’s superiority.