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•  POSSIBLY HELPFUL  In patients treated surgically for melanoma with lymph node involvement but no distant metastases and with a BRAF V600 mutation, adjuvant treatment with the combination of dabrafenib and trametinib reduced the 3-year recurrence rate by about 20 percentage points in a single double-blind randomised placebo-controlled trial in 870 patients. Interim results suggest that this combination extends survival, although confirmation from longer-term follow-up is required. These potential benefits must be weighed against the increased incidence of serious adverse events reported with dabrafenib + trametinib (36% of patients versus 10% in the placebo group). In the absence of head-to-head trials, it is not known whether this combination is superior to nivolumab or pembrolizumab. When dabrafenib + trametinib is chosen, patients should be closely monitored, in particular for cutaneous, visual, renal, hepatic and cardiac harms.

©Prescrire 1 June 2020

Source: "Dabrafenib - Tafinlar° and trametinib - Mekinist° combined, as adjuvant therapy for stage III melanoma with a BRAF V600 mutation. Lower risk of recurrence, but more adverse effects and no comparison with other antineoplastics" Prescrire International 2020; 29 (216): 147-149. Subscribers only.

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