Dr. Flaherty on the COLUMBUS Trial Updates in BRAF-Mutant Melanoma

Keith T. Flaherty, MD, director, Henri and Belinda Termeer Center for Targeted Therapy, Massachusetts General Hospital Cancer Center, and professor of medicine, Harvard Medical School, discusses an update on overall survival (OS) in COLUMBUS, a randomized phase III trial of encorafenib (Braftovi) plus binimetinib (Mektovi) versus vemurafenib (Zelboraf) or encorafenib in patients with BRAF V600-mutant melanoma.

The primary purpose of this trial was to evaluate the efficacy and safety of the this BRAF/MEK combination. Dabrafenib (Tafinlar) and trametinib (Mekinist) were the first BRAF/MEK combination to be approved in 2014. About 1.5 years later, vemurafenib and cobimetinib (Cotellic) were approved as well, according to Flaherty. Those were emerging as the COLUMBUS trial was designed and executed. The trial examined encorafenib plus binimetinib to see if it was a BRAF/MEK inhibitor combination that would be superior to a BRAF inhibitor.

The secondary purpose of the study tested to see if encorafenib was a better BRAF inhibitor than vemurafenib, according to Flaherty. Within this trial, encorafenib and vemurafenib was compared directly. There was a statistically significant improvement in outcome in progression-free survival and OS in patients who received encorafenib, according to Flaherty.