Authors' objectives: What is the efficacy and effectiveness of BRAF and MEK inhibitors for the treatment of patients with active or symptomatic MBM? What is the safety of BRAF and MEK inhibitors for the treatment of patients with active or symptomatic MBM? What are the evidence-based guidelines regarding the use of BRAF and MEK inhibitors for the treatment of patients with active or symptomatic MBM?

Authors' results and conclusions: This rapid review examines the clinical efficacy, effectiveness, and safety of BRAF and MEK inhibitors as a treatment for patients with active or symptomatic melanoma brain metastasis (MBM) Three primary studies and 4 clinical practice guidelines met the eligibility criteria for this rapid review. No systematic reviews (SRs) were found. There are very few studies examining the effectiveness and safety of BRAF and MEK inhibitors in patients with active or symptomatic MBM. The limited number of primary studies available are of low quality and are subject to significant risk of bias. Three single-arm, low-quality cohort studies published since 2019 were identified: 2 providing data on median progression-free survival (PFS) (approximately 5 months), 2 providing data on overall survival (OS) (approximately 7 to 9 months), and the third providing narrative descriptions only. Adverse effects were reported in 1 study. No comparative studies were located. The 3 primary studies reported that patients may survive for up to 5 months without their symptoms worsening, and their OS rates were between 7.4 months to 9.5 months after receiving BRAF and MEK inhibitor combination therapy. In 1 study, common side effects included fever, rash, and fatigue, and some patients stopped treatment primarily because of fever and abnormal liver function. The clinical practice guidelines considered our patient population, but the resulting recommendations did not differentiate between patients with and without active or symptomatic MBM or did not refer specifically to BRAF and MEK inhibitors. Instead, most recommendations focused on other treatments, such as surgery.

Project Status: Completed

URL for project: https://www.cda-amc.ca/braf-and-mek-inhibitors-active-or-symptomatic-melanoma-brain-metastasis

Year Published: 2024

URL for published report: https://www.cda-amc.ca/sites/default/files/pdf/htis/2024/RC1549-BRAF-MEK-Melanoma.pdf

English language abstract: An English language summary is available

Publication Type: Rapid Review

Country: Canada

Organisation Name: Canada’s Drug Agency (CDA-AMC)

Contact Address: 865 Carling Ave., Suite 600 Ottawa, ON Canada K1S 5S8

Contact Name: Shannon Nordstrom

Contact Email: shannon.nordstrom@cda-amc.ca

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