title: Cessation of targeted therapy after a complete response in BRAF-mutant advanced melanoma: a case series.
abstract: BACKGROUND
  It is unknown whether melanoma patients achieving complete response (CR) with targeted therapy can safely discontinue treatment.
  
  
  METHODS
  All patients treated with BRAF/MEK inhibitors achieving CR and ceasing treatment before progression were identified. Clinical data at treatment initiation, cessation and progression were examined.
  
  
  RESULTS
  A total of 12 eligible patients were identified, with median follow-up of 16 months, of whom 6 (50%) recurred at a median of 6.6 months after treatment cessation. One patient lost to follow-up until presentation with symptomatic recurrence was the only relapser to die. At relapse, the remaining five patients had an LDH <1.2 times ULN, four were ECOG 0 and one ECOG 1. Baseline characteristics and time to CR and to discontinuation did not influence the rate of relapse.
  
  
  CONCLUSIONS
  A large proportion of patients achieving CR with BRAF/MEK inhibitors relapse after treatment cessation. The optimal treatment duration in such patients is unclear, particularly where alternative treatments are available.
authors.affiliation: Melanoma Institute Australia and The University of Sydney, Sydney, New South Wales, Australia.|Crown Princess Mary Cancer Centre Westmead, Sydney, New South Wales, Australia.|University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Matteo S
authors.initials: MS
authors.lastname: Carlino
authors.affiliation: Istituto Nazionale per lo Studio e la Cura dei Tumori Fondazione 'G. Pascale', Via Mariano Semmola, 80131 Napoli, Italy.
authors.forename: Vito
authors.initials: V
authors.lastname: Vanella
authors.affiliation: Crown Princess Mary Cancer Centre Westmead, Sydney, New South Wales, Australia.
authors.forename: Christina
authors.initials: C
authors.lastname: Girgis
authors.affiliation: Regina Elena National Cancer Institute, Rome, Italy.
authors.forename: Diana
authors.initials: D
authors.lastname: Giannarelli
authors.affiliation: Melanoma Institute Australia and The University of Sydney, Sydney, New South Wales, Australia.|University of Sydney, Sydney, New South Wales, Australia.|Royal North Shore Hospital, Sydney, New South Wales, Australia.
authors.forename: Alex
authors.initials: A
authors.lastname: Guminski
authors.affiliation: Istituto Nazionale per lo Studio e la Cura dei Tumori Fondazione 'G. Pascale', Via Mariano Semmola, 80131 Napoli, Italy.
authors.forename: Lucia
authors.initials: L
authors.lastname: Festino
authors.affiliation: Melanoma Institute Australia and The University of Sydney, Sydney, New South Wales, Australia.|Crown Princess Mary Cancer Centre Westmead, Sydney, New South Wales, Australia.|Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia.
authors.forename: Richard F
authors.initials: RF
authors.lastname: Kefford
authors.affiliation: Melanoma Institute Australia and The University of Sydney, Sydney, New South Wales, Australia.|University of Sydney, Sydney, New South Wales, Australia.|Royal North Shore Hospital, Sydney, New South Wales, Australia.
authors.forename: Alexander M
authors.initials: AM
authors.lastname: Menzies
authors.affiliation: Melanoma Institute Australia and The University of Sydney, Sydney, New South Wales, Australia.|University of Sydney, Sydney, New South Wales, Australia.|Royal North Shore Hospital, Sydney, New South Wales, Australia.
authors.forename: Georgina V
authors.initials: GV
authors.lastname: Long
authors.affiliation: Istituto Nazionale per lo Studio e la Cura dei Tumori Fondazione 'G. Pascale', Via Mariano Semmola, 80131 Napoli, Italy.
authors.forename: Paolo A
authors.initials: PA
authors.lastname: Ascierto
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000188:drug therapy* / Q000235:genetics; D008875:Middle Aged; D009154:Mutation; D048493:Proto-Oncogene Proteins B-raf / Q000037:antagonists & inhibitors / Q000235:genetics*; D012008:Recurrence; D016019:Survival Analysis
chemical_list: D000970:Antineoplastic Agents; C482119:BRAF protein, human; D048493:Proto-Oncogene Proteins B-raf