Evidence map›Paper›PMID 40345056›Full record

Trial reportESMO open2025

Early switch from run-in with targeted to immunotherapy in advanced BRAF

E Livingstone, H J Gogas, L Kandolf, F Meier, T K Eigentler, M Ziemer, P Terheyden, A Gesierich, R A Herbst, K C Kähler and 15 more

Abstract readClinical Trial, Phase IIRandomized Controlled Trial
In one paragraph

Trial report in ESMO open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

25 authors.

E LivingstoneDepartment of Dermatology, University Hospital Essen, Essen, Germany; German Cancer Consortium, Partner Site Essen, Essen, Germany; National Center for Tumor Diseases (NCT-West), Campus Essen, Essen, Germany.
H J GogasFirst Department of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
L KandolfDermatology Department, Faculty of Medicine, Military Medical Academy, Belgrade, Serbia.
F MeierDepartment of Dermatology, University Hospital Carl Gustav Carus Dresden, Technical University Dresden, Dresden, Germany; Skin Cancer Center at the University Cancer Centre and National Center for Tumor Diseases, Dresden, Germany.
T K EigentlerDepartment of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Centre for Dermatooncology, Department of Dermatology, Eberhard-Karls University Tübingen, Tübingen, Germany.
M ZiemerDepartment of Dermatology, Universitätsklinikum Leipzig, Leipzig, Germany.
P TerheydenDepartment of Dermatology, University Hospital Schleswig-Holstein, Lübeck, Germany.
A GesierichDepartment of Dermatology, University Hospital Würzburg, Würzburg, Germany.
R A HerbstDepartment of Dermatology, HELIOS-Klinikum Erfurt, Erfurt, Germany.
K C KählerDepartment of Dermatology, Venerology, and Allergology, University Hospital Schleswig-Holstein, Kiel, Germany.
D C ZiogasInternal Medicine Department, Laiko General Hospital of Athens, Athens, Greece.
Ž MijuškovićDermatology Department, Faculty of Medicine, Military Medical Academy, Belgrade, Serbia.
M GarzarolliDepartment of Dermatology, University Hospital Carl Gustav Carus Dresden, Technical University Dresden, Dresden, Germany; Skin Cancer Center at the University Cancer Centre and National Center for Tumor Diseases, Dresden, Germany.
C GarbeCentre for Dermatooncology, Department of Dermatology, Eberhard-Karls University Tübingen, Tübingen, Germany.
A RoeschDepartment of Dermatology, University Hospital Essen, Essen, Germany; German Cancer Consortium, Partner Site Essen, Essen, Germany; National Center for Tumor Diseases (NCT-West), Campus Essen, Essen, Germany.
S UgurelDepartment of Dermatology, University Hospital Essen, Essen, Germany; German Cancer Consortium, Partner Site Essen, Essen, Germany; National Center for Tumor Diseases (NCT-West), Campus Essen, Essen, Germany.
R GutzmerDepartment of Dermatology, Skin Cancer Center Hannover, Hannover Medical School, Hannover, Germany; Department of Dermatology, Johannes Wesling Medical Center, Ruhr University Bochum, Minden, Germany.
C Gaudy-MarquesteAix-Marseille University, (APHM), Timone Hospital, Dermatology and Skin Cancer Department, Marseille, France.
F KieckerDepartment of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Dermatologie am Schlachtensee, Berlin, Germany.
J UtikalSkin Cancer Unit, German Cancer Research Center (DKFZ), Heidelberg, Germany; Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Ruprecht-Karl University of Heidelberg, Mannheim, Germany; DKFZ Hector Cancer Institute at the University Medical Center Mannheim, Mannheim, Germany.
M HartmannEuropean Consulting & Contracting in Oncology, Trier, Germany.
S MietheAlcedis GmbH, Giessen, Germany.
S EckhardtAlcedis GmbH, Giessen, Germany.
L ZimmerDepartment of Dermatology, University Hospital Essen, Essen, Germany; German Cancer Consortium, Partner Site Essen, Essen, Germany; National Center for Tumor Diseases (NCT-West), Campus Essen, Essen, Germany.
D SchadendorfDepartment of Dermatology, University Hospital Essen, Essen, Germany; German Cancer Consortium, Partner Site Essen, Essen, Germany; National Center for Tumor Diseases (NCT-West), Campus Essen, Essen, Germany; Research Alliance Ruhr, Research Center One Health, University Duisburg-Essen, Essen, Germany. Electronic address: Dirk.Schadendorf@uk-essen.de.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundOptimal sequencing of immune checkpoint inhibitors (ICIs) and targeted therapies (TTs) in BRAF PATIENTS AND

methodsThe 1 : 1 randomised phase II ImmunoCobiVem trial compared-after a 3-month run-in phase with vemurafenib (VEM, 960 mg twice daily) and cobimetinib (COB, 60 mg daily days 21-28, q4w)-continuous VEM + COB until disease progression (PD1) and second-line atezolizumab (ATEZO, 1200 mg, q3w) in arm A versus early switch to ATEZO after run-in, followed by crossover to VEM + COB at PD1, in arm B. PFS from the start of run-in until PD1 was the primary endpoint (PFS1); secondary efficacy endpoints were OS, overall PFS (PFS2) and PFS3 (time from PD1 to PD after crossover, i.e. PD2) and best overall response rates (BORRs).

resultsThe final analysis (median follow-up 57.0 months, interquartile range 22.7-63.0 months) confirmed longer PFS1 for continuous TT [arm A (69 patients) versus arm B (early switch, 66 patients); hazard ratio (HR) 0.61, 95% confidence interval (CI) 0.41-0.91, P = 0.006], but early switch to ICIs resulted in better long-term OS [4- and 5-year landmark OS 42% (95% CI 29% to 55%) and 40% (95% CI 27% to 53%) for arm A, and 53% (95% CI 38% to 65%) and 45% (95% CI 31% to 58%) for arm B; descriptive HR 1.17, 95% CI 0.71-1.91]. Absolute BORRs were 81% and 89%, respectively, with 15 (22%) and 19 (29%) patients achieving a complete response at least once along each sequence. At crossover, TT retreatment (arm B) resulted in higher PFS3 than second-line ICI (arm A).

conclusionsEarly switch to ICIs after TT run-in (arm B) led to an improved, although not statistically significant, 4- and 5-year landmark OS compared with arm A. No subgroups were identified for which a TT run-in provided clinical benefit. The number of patients developing brain metastasis and the time to brain metastasis were not improved by an early TT to ICI switch.

Indexed as

Antineoplastic Combined Chemotherapy ProtocolsImmune Checkpoint InhibitorsImmunotherapyMelanomaProto-Oncogene Proteins B-rafAdultAgedAntibodies, Monoclonal, HumanizedAzetidinesFemaleHumansMaleMiddle AgedMolecular Targeted TherapyPiperidinesVemurafenibAntibodies, Monoclonal, HumanizedatezolizumabAzetidinesBRAF protein, humancobimetinibImmune Checkpoint InhibitorsPiperidinesProto-Oncogene Proteins B-rafVemurafenibcrossover designimmunotherapymelanomasequential therapytargeted therapy

Identifiers

PMID40345056
PMCPMC12136786

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

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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.