Efficacy of encorafenib plus binimetinib in patients with BRAF-mutated melanoma brain metastases: Results from the Dutch Melanoma Treatment Registry

M. Bloem*, K. P.M. Suijkerbuijk, M. J.B. Aarts, F. W.P.J. van den Berkmortel, C. U. Blank, W. A.M. Blokx, M. J. Boers-Sonderen, C. D.M. Boreel, J. W.B. de Groot, J. B.A.G. Haanen, G. A.P. Hospers, E. Kapiteijn, O. J. van Not, D. Piersma, B. Rikhof, A. M. Stevense-den Boer, A. A.M. van der Veldt, G. Vreugdenhil, M. W.J.M. Wouters, A. J.M. van den Eertwegh

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Aim: Data on the effectiveness of encorafenib/binimetinib in melanoma patients with brain metastases (BMs) are limited. Methods: All patients with BRAF V600-mutated melanoma and BMs treated with encorafenib/binimetinib between 2019 and 2022 in the Netherlands were included from the nationwide Dutch Melanoma Treatment Registry. Patients previously treated with other BRAF/MEK inhibitors were excluded. We analyzed objective response rates (ORR), progression-free survival (PFS), and overall survival (OS). Multivariable Cox regression identified factors associated with survival. Subgroup analyses included asymptomatic versus symptomatic BMs and line of treatment (first-line versus later-line). Results: In total, 190 patients were included. Symptomatic BMs were present in 63 % of patients. Encorafenib/binimetinib was the first-line treatment in 64 % of all patients, while 36 % had prior immunotherapy. Overall, the ORR was 69.4 %, median PFS was 5.5 months (95 %CI 4.9–6.2), and median OS 11.9 months (95 %CI 10.0–15.7). Age = 70, ECOG PS = 2, symptomatic BMs, and elevated LDH were significantly associated with worse survival. Patients with prior immunotherapy had a median PFS of 6.9 months (95 %CI 4.3–9.6) and OS of 17.9 months (95 %CI 13.7–31.2), while this was 4.9 months (95 %CI 4.3–5.5) and 10.1 months (95 %CI 8.1–13.0) in treatment-naïve patients. Median PFS and OS in patients with asymptomatic versus symptomatic BMs were 6.1 months (95 %CI 4.9–9.8) and 20.5 (95 %CI 14.0-NA) versus 5.3 months (95 %CI 4.9–6.3) and 10.7 (95 %CI 8.9–13.7), respectively. Conclusions: Encorafenib/binimetinib has clinical activity in real-world melanoma patients with BMs. Their prognosis is determined by the presence of symptomatic BMs, age, ECOG PS, and LDH levels.
Original languageEnglish
Article number115514
JournalEuropean Journal of Cancer
Volume223
DOIs
Publication statusPublished - 18 Jun 2025

Keywords

  • Advanced melanoma
  • Binimetinib
  • BRAF/MEK inhibitors
  • Brain metastases
  • Encorafenib

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