First-line BRAF/MEK inhibitors versus anti-PD-1 monotherapy in BRAF(V600)-mutant advanced melanoma patients: a propensity-matched survival analysis

J. van Breeschoten, M.W.J.M. Wouters, D.L. Hilarius, J.B. Haanen, C.U. Blank, M.J.B. Aarts, F.W.P.J. van den Berkmortel, J.W.B. de Groot, G.A.P. Hospers, E. Kapiteijn, D. Piersma, R.S. van Rijn, K.P.M. Suijkerbuijk, W.A.M. Blokx, B.J.J. ten Tije, A.A.M. van der Veldt, A. Vreugdenhil, M.J. Boers-Sonderen, A.J.M. van den Eertwegh*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Background Anti-PD-1 antibodies and BRAF/MEK inhibitors are the two main groups of systemic therapy in the treatment of BRAF(V600)-mutant advanced melanoma. Until now, data are inconclusive on which therapy to use as first-line treatment. The aim of this study was to use propensity score matching to compare first-line anti-PD-1 monotherapy vs. BRAF/MEK inhibitors in advanced BRAF(V600)-mutant melanoma patients. Methods We selected patients diagnosed between 2014 and 2017 with advanced melanoma and a known BRAF(V600)-mutation treated with first-line BRAF/MEK inhibitors or anti-PD-1 antibodies, registered in the Dutch Melanoma Treatment Registry. Patients were matched based on their propensity scores using the nearest neighbour and the optimal matching method. Results Between 2014 and 2017, a total of 330 and 254 advanced melanoma patients received BRAF/MEK inhibitors and anti-PD-1 monotherapy as first-line systemic therapy. In the matched cohort, patients receiving anti-PD-1 antibodies as a first-line treatment had a higher median and 2-year overall survival compared to patients treated with first-line BRAF/MEK inhibitors, 42.3 months (95% CI: 37.3-NE) vs. 19.8 months (95% CI: 16.7-24.3) and 85.4% (95% CI: 58.1-73.6) vs. 41.7% (95% CI: 34.2-51.0). Conclusions Our data suggest that in the matched BRAF(V600)-mutant advanced melanoma patients, anti-PD-1 monotherapy is the preferred first-line treatment in patients with relatively favourable patient and tumour characteristics.
Original languageEnglish
Pages (from-to)1222-1230
Number of pages9
JournalBritish Journal of Cancer
Issue number7
Early online date26 Jan 2021
Publication statusPublished - 30 Mar 2021


  • dabrafenib
  • ipilimumab
  • metastatic melanoma
  • nivolumab
  • pembrolizumab
  • phase-3
  • pooled analysis
  • vemurafenib
  • PHASE-3


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