Reinhard Georg Dummer, MD
For patients with NRAS
-mutant melanoma who progress following treatment with an immunotherapy agent, the MEK inhibitor binimetinib offers a promising option, explains Reinhard Georg Dummer, MD.
OncLive: Can you provide an overview of the NEMO trial?
: NEMO was designed 4 years ago based on data that the MEK inhibitor binimetinib can increase the response rate in patients with NRAS
-mutated melanoma. There are several melanoma subtypes based on driver mutations in an important pathway, which is called the MAPK pathway. Most of them are mutated for BRAF
, and there are many medications around for BRAF
-mutated patients. However, 20% are mutated for NRAS
and, here, we don’t have any specific treatments, although there is a huge medical need.
What are the exciting takeaways from this study?
This study is a prospective randomized trial in a very special patient population and, also, was in an environment of competitive recruitment with many other studies. Nevertheless, the study managed to recruit patients and randomize them to binimetinib or the standard chemotherapy that is used worldwide, which is dacarbazine.
What is the safety profile of this agent?
We know a lot about MEK inhibitors. Most of the adverse events are mild; to manage them, you need to know them. There are certain organs that are affected the most, and there are muscular toxicities that are reflected by an elevation by the muscle enzyme CPK.
Also, there are some skin toxicities. Patients may get a rash, which can look like very severe acne, so you have to help them as it can interfere with their social life. It is not dangerous, but it’s very unpleasant for patients.
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