Evidence map›Paper›PMID 28284557›Full record

Trial reportThe Lancet. Oncology2017

Binimetinib versus dacarbazine in patients with advanced NRAS-mutant melanoma (NEMO): a multicentre, open-label, randomised, phase 3 trial.

Reinhard Dummer, Dirk Schadendorf, Paolo A Ascierto, Ana Arance, Caroline Dutriaux, Anna Maria Di Giacomo, Piotr Rutkowski, Michele Del Vecchio, Ralf Gutzmer, Mario Mandala and 14 more

Registry-linked trialOpen access · greenAbstract readClinical Trial, Phase IIIComparative StudyMulticenter Study
PubMed Publisher
In one paragraph

Trial report in The Lancet. Oncology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04059224 (TraMel-WT), which is not on this map. Cited by 259 papers, 13 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
259citing papers in PubMed, 13 pooled it
20.5field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04059224 phase2completednot on this mapstarted 2019, after this paper: background citation

TraMel-WT: A Stratified Dual-stratum Open-label Two-stage Phase 2 Trial of Trametinib in Patients With Advanced Pretreated BRAFV600 Wild-type Melanoma

TypeinterventionalSponsorUniversitair Ziekenhuis BrusselRan2019 to 2023Enrolled45ConditionsStage IV Melanoma, Stage III MelanomaArmsTrametinib, Dabrafenib
3 · Its place in the literature

Who cites it

259 citing papers in PubMed, 13 syntheses or guidelines pooled it, 485 citations in OpenAlex.

  1. Pooled it
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  4. Cutaneous melanoma: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up.Annals of oncology : official journal of the European Society for Medical Oncology · 2025
    Guideline
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  6. SEOM-GEM clinical guidelines for cutaneous melanoma (2023).Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2024
    Guideline
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  11. The Predictive Value ofFrontiers in immunology · 2021
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  17. Differential Outcomes in Codon 12/13 and Codon 61Clinical cancer research : an official journal of the American Association for Cancer Research · 2021
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199 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

24 authors at 19 institutions in 11 countries.

Reinhard DummerDepartment of Dermatology, University Hospital Zürich Skin Cancer Center, Zürich, Switzerland. Electronic address: reinhard.dummer@usz.ch.
Dirk SchadendorfDepartment of Dermatology, University Hospital Essen, Essen, Germany; German Cancer Consortium, Heidelberg, Germany.
Paolo A AsciertoMelanoma Unit, Cancer Immunotherapy and Innovative Therapies, Istituto Nazionale Tumori Fondazione Pascale, Via Mariano Semmola, Naples, Italy.
Ana AranceDepartment of Medical Oncology, Hospital Clinic of Barcelona, Barcelona, Spain.
Caroline DutriauxDepartment of Oncologic Dermatology, Centre Hospitalier Universitaire de Bordeaux, Hôpital Saint-André, Bordeaux, France.
Anna Maria Di GiacomoMedical Oncology and Immunotherapy, University Hospital of Siena, Viale Bracci, Siena, Italy.
Piotr RutkowskiDepartment of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland.
Michele Del VecchioDepartment of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Giacomo Venezian, Milan, Italy.
Ralf GutzmerDepartment of Dermatology and Allergy, Skin Cancer Center Hannover, Hannover Medical School, Hannover, Germany.
Mario MandalaDepartment of Oncology and Haematology, Papa Giovanni XXIII Cancer Center Hospital, Bergamo, Italy.
Luc ThomasDepartment of Dermatology, Centre Hospitalier Lyon Sud, Lyons Cancer Research Center, Lyon 1 University, Pierre Bénite, France.
Lev DemidovN N Blokhin Russian Cancer Research Center, Ministry of Health, Moscow, Russian Federation.
Claus GarbeDepartment of Dermatology, University Hospital Tuebingen, Tuebingen, Germany.
David HoggDepartment of Medicine, University Health Network/Princess Margaret Hospital, Toronto, ON, Canada.
Gabriella LiszkayDepartment of Dermatology, National Institute of Oncology, Budapest, Hungary.
Paola QueiroloDepartment of Medical Oncology, Institute for Cancer Research, IRCCS San Martino, Largo Rosanna Benzi, Genova, Italy.
Ernesto WassermanNovartis Pharmaceuticals Corporation, One Health Plaza, East Hanover, NJ, USA.
James FordNovartis Pharmaceuticals Corporation, One Health Plaza, East Hanover, NJ, USA.
Marine WeillNovartis Pharma AG, Basel, Switzerland.
L Andres SirulnikNovartis Pharmaceuticals Corporation, One Health Plaza, East Hanover, NJ, USA.
Valentine JehlNovartis Pharma AG, Basel, Switzerland.
Viviana BozónArray BioPharma, Boulder, CO, USA.
Georgina V LongMelanoma Institute Australia, The University of Sydney, Royal North Shore and Mater Hospitals, Sydney, NSW, Australia.
Keith FlahertyDepartment of Medical Oncology, Massachusetts General Hospital, Boston, MA, USA.
Novartis (Switzerland) · CHArray BioPharma (United States) · USCentre Hospitalier Universitaire de Bordeaux · FRFondazione IRCCS Istituto Nazionale dei Tumori · ITGerman Cancer Research Center · DEHospital Clínic de Barcelona · ESIstituto Nazionale Tumori IRCCS "Fondazione G. Pascale" · ITMassachusetts General Hospital · USMedizinische Hochschule Hannover · DENational Institute of Oncology · HUOspedale Papa Giovanni XXIII · ITOspedale Policlinico San Martino · ITRussian Cancer Research Center NN Blokhin · RUThe Maria Sklodowska-Curie National Research Institute of Oncology · PLThe University of Sydney · AUUniversité Claude Bernard Lyon 1 · FRUniversity Health Network · CAUniversity of Siena · ITUniversity of Tübingen · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThere are no established therapies specific for NRAS-mutant melanoma despite the emergence of immunotherapy. We aimed to assess the efficacy and safety of the MEK inhibitor binimetinib versus that of dacarbazine in patients with advanced NRAS-mutant melanoma.

methodsNEMO is an ongoing, randomised, open-label phase 3 study done at 118 hospitals in 26 countries. Patients with advanced, unresectable, American Joint Committee on Cancer stage IIIC or stage IV NRAS-mutant melanoma who were previously untreated or had progressed on or after previous immunotherapy were randomised (2:1) to receive either binimetinib 45 mg orally twice daily or dacarbazine 1000 mg/m

findingsBetween Aug 19, 2013, and April 28, 2015, 402 patients were enrolled and randomly assigned, 269 to binimetinib and 133 to dacarbazine. Median follow-up was 1·7 months (IQR 1·4-4·1). Median progression-free survival was 2·8 months (95% CI 2·8-3·6) in the binimetinib group and 1·5 months (1·5-1·7) in the dacarbazine group (hazard ratio 0·62 [95% CI 0·47-0·80]; one-sided p<0·001). Grade 3-4 adverse events seen in at least 5% of patients the safety population in either group were increased creatine phosphokinase (52 [19%] of 269 patients in the binimetinib group vs none of 114 in the dacarbazine group), hypertension (20 [7%] vs two [2%]), anaemia (five [2%] vs six [5%]), and neutropenia (two [1%] vs ten [9%]). Serious adverse events (all grades) occurred in 91 (34%) patients in the binimetinib group and 25 (22%) patients in the dacarbazine group.

interpretationBinimetinib improved progression-free survival compared with dacarbazine and was tolerable. Binimetinib might represent a new treatment option for patients with NRAS-mutant melanoma after failure of immunotherapy.

fundingArray BioPharma and Novartis Pharmaceuticals Corporation.

Indexed as

AdultAgedAged, 80 and overAntineoplastic Combined Chemotherapy ProtocolsBenzimidazolesDacarbazineFemaleFollow-Up StudiesGTP PhosphohydrolasesHumansMaleMelanomaMembrane ProteinsMiddle AgedMutationNeoplasm StagingBenzimidazolesbinimetinibDacarbazineGTP PhosphohydrolasesMembrane ProteinsNRAS protein, human

Identifiers

PMID28284557
OpenAlexW2594529508

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.