Selumetinib Aids Short-Term Outcomes in Uveal Melanoma
(HealthDay News) — For patients with advanced uveal melanoma, selumetinib treatment is associated with modestly improved progression-free survival and response rates, but no improvement in overall survival compared to chemotherapy, according to a study published June 18 in the Journal of the American Medical Association.
Richard D. Carvajal, MD, from Memorial Sloan-Kettering Cancer Center in New York, and colleagues randomized 101 patients (1:1) with metastatic uveal melanoma to receive selumetinib, 75mg orally twice daily on a continual basis (n=50), or chemotherapy (temozolomide, 150mg/m2 orally daily for 5 of every 28 days, or dacarbazine, 1,000mg/m2 intravenously every 21 days [investigator choice]; (n=51) until disease progression, death, intolerable adverse effects, or withdrawal of consent.
The researchers found that median progression-free survival among patients randomized to chemotherapy was seven weeks and was 15.9 weeks among those randomized to selumetinib (hazard ratio [HR],0.46; P<.001). With chemotherapy median overall survival time was 9.1 months and was 11.8 months with selumetinib (HR, 0.66; 95% CI, 0.41–1.06; P=.09). There were no objective responses seen with chemotherapy, while 49% of patients treated with selumetinib achieved tumor regression and 14% achieving an objective radiographic response to therapy. The majority of patients treated with selumetinib (97%) had treatment-related adverse events, with 37% requiring at least 1 dose reduction.
"Improvement in clinical outcomes was accompanied by a high rate of adverse events," the authors write.
Several authors disclose financial ties to the pharmaceutical industry, and one author reports receiving travel reimbursements from AstraZeneca, manufacturer of selumetinib.