Bali Dermatology and Venereology Journal
Vol 3, No 2 (2020)

Focus on the dabrafenib, vemurafenib, and trametinib in clinical outcome of melanoma: a systematic review and meta-analysis

Widya Anjani, Ida Ayu (Unknown)
Indrakusuma, Anak Agung Bagus Putra (Unknown)
Arim Sadeva, I Gede Krisna (Unknown)
Wulandari, Putri Ayu (Unknown)
Rusyati, Luh Made Mas (Unknown)
Sudarsa, Prima Sanjiwani Saraswati (Unknown)
Supadmanaba, I Gede Putu (Unknown)
Wihandani, Desak Made (Unknown)



Article Info

Publish Date
15 Dec 2020

Abstract

Background: Melanoma is the most serious lethal skin cancer, affects the melanin producer cells (melanocytes). Surgery is the most common treatment, whereas for the advance stage the development of a treatment is recommended. BRAF (Dabrafenib and Vemurafenib) inhibitor or MEK inhibitor (Trametinib) is used as the most frequently targeted therapy of melanoma due to more than 80% patient with positive BRAF mutation. In this review, those treatments will be investigated systematically to identify their clinical outcome.Method: This systematic literature review (SLR) was performed from Cochrane, Science Direct, Google Scholar, and Pubmed. Cochrane Risk-of-Bias Tool RoB2 is used to assess RCT studies and New-castle Ottawa Scale Assessment to assess cohort studies by 3 different assessors. Data analysis was carried out by using Review Manager (RevMan 5.4). Heterogenicity test was assessed by I2  and Chi2 statisticResult: There are 20 studies used in this article (13 RCT and 7 cohorts). The overall survival (OS) and progression-free survival (PFS) of study that using targeted therapy (vemurafenib, trametinib, or dabrafenib) compare other therapies (chemotherapy, immunotherapy,etc) showed risk ratio (RR) was 1.12 (95%CI 1.07,1.17;  I2=100%; p<0,00001). The OS and PFS with monotherapy compare of vemurafenib, trametinib, or dabrafenib with combination therapy showed RR was 1.09 (95%CI.06,1.13;I2=99%; p<0,00001). Conclusion: BRAF and MEK targeted therapy has a good prognosis for a patient with a positive BRAF gene mutation and could be combined with other therapy for a better clinical outcome rather than monotherapy.Keyword: melanoma, dabrafenib, vemurafenib, and trametinib

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Journal Info

Abbrev

bdv

Publisher

Subject

Biochemistry, Genetics & Molecular Biology Medicine & Pharmacology

Description

Bali Journal of dermatology and venereology is published by Department of dermatology and venereology, Udayana University, Bali, Indonesia. Bali Journal of dermatology and venereology is an open access, peer reviewed journal aiming to communicate high quality research articles, reviews and general ...