Dr. Keith T. Flaherty on the NEMO Trial in NRAS-Mutant Melanoma

Keith T. Flaherty, MD, director of Developmental Therapeutics at the Cancer Center of Massachusetts General Hospital, discusses the phase III NEMO trial, which found that binimetinib reduced the risk of progression or death by 38% when compared with dacarbazine in patients with NRAS-mutant melanoma.

Twenty to 25% of melanoma patients have NRAS mutations. It is possible that these patients have MAP kinase pathway dependence, said Flaherty. In several phase II trials, MEK inhibitors have show a 15-20% response rate in NRAS mutant melanoma. The NEMO trial was launched as the first phase III trial to test a MEK inhibitor, binimetinib, versus standard of care. This trial was launched several years ago and most patients were treatment-naïve, but some had previously recieved an immunotherapy agent.

The trial aims to investigate how patients would respond to this drug following immunotherapy, which is where it is anticipated to have a role, said Flaherty.

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