Date of Award
Selective Evidence-Based Medicine Review
Master of Science in Health Sciences - Physician Assistant
Physician Assistant Studies
John Cavenagh, MBA, PhD, PA-C
OBJECTIVE: The objective of this selective EBM review is to determine whether or not “Do BRAF inhibitors improve survival in patients with BRAF V600E mutant melanoma?”
STUDY DESIGN: Review of primary literature sources that examined survival rates in BRAF V600E mutant melanoma patients receiving treatment with a BRAF inhibitor.
DATA SOURCES: Two randomized controlled trials and one cohort study evaluating the use of BRAF inhibitors in patients with BRAF V600E mutant melanoma were found using OVID, Medline, and PubMed.
OUTCOMES MEASURED: Overall survival and progression free survival were the outcomes measured to determine survival rates in patients with BRAF V600E mutant melanoma.
RESULTS: Chapman et al demonstrates an overall survival rate of 84% for Vemurafenib (95% CI, 78-89) compared to 64% for Dacarbazine (95% CI, 56-73). Progression free survival was 5.3 months for Vemurafenib compared to 1.6 months for Dacarbazine. Sosman et al, a cohort study, demonstrates an overall survival rate of 58% (95% CI, 49-67) after 12 months. Progression free survival was 6.8 months (95% CI, 5.6-8.1). Hauschild et al demonstrates an overall survival rate of 57% for Dabrafenib compared to 22% for Dacarbazine. Progression free survival was 5.1 months for Dabrafenib compared to 2.7 months for Dacarbazine.
CONCLUSIONS: All studies reported longer periods of progression free survival and an increase in overall response rates. This suggests that BRAF inhibitors improve survival in patients with V600E mutant melanoma.
Stamm, Sarah E., "Do BRAF Inhibitors Improve Survival in Patients With BRAF V600E Mutant Melanoma?" (2015). PCOM Physician Assistant Studies Student Scholarship. 250.