Longitudinal Genomic Analysis to Fine-tune Targeted Therapy: Results of the Phase II LOGIC 2 Trial in Patients with BRAFV600-Mutant Metastatic Melanoma

Dummer, R; Miller, WH, Jr; Sandhu, S; Mu&#241;oz-Couselo, E; Burris, HA, 3rd; Butler, MO; Taylor, MH; Heinzerling, L; Blank, CU; Postow, MA; Chmielowski, B; Middleton, MR; Berking, C; Hassel, JC; Gesierich, AH; Mauch, C; Kleha, JF; Polli, A; Harney, AS; di Pietro, A; Ascierto, PA

Author(s): Dummer, R; Miller, WH, Jr; Sandhu, S; Muñoz-Couselo, E; Burris, HA, 3rd; Butler, MO; Taylor, MH; Heinzerling, L; Blank, CU; Postow, MA; Chmielowski, B; Middleton, MR; Berking, C; Hassel, JC; Gesierich, AH; Mauch, C; Kleha, JF; Polli, A; Harney, AS; di Pietro, A; Ascierto, PA;
Details: Publication Year 2025-06-03,Volume 31,Issue #11,Page 2097-2107
Journal Title: Clinical Cancer Research
Publication Type: Research article
Abstract: PURPOSE: LOGIC 2 (NCT02159066), a multicenter, open-label, two-part, phase II study, assessed encorafenib plus binimetinib combined with a third targeted agent after tumor progression on encorafenib plus binimetinib in patients with locally advanced, unresectable or metastatic BRAFV600-mutant melanoma. PATIENTS AND METHODS: Adults with locally advanced, unresectable or metastatic BRAFV600-mutant melanoma who were BRAF inhibitor/MEK inhibitor (BRAFi/MEKi) treatment-naïve or pretreated received encorafenib plus binimetinib (part I/run-in). Based on the genomic testing at disease progression following encorafenib plus binimetinib, patients were assigned to one of four treatment arms to receive encorafenib plus binimetinib with an appropriate molecularly targeted agent (ribociclib, infigratinib, capmatinib, or buparlisib; part II). The primary endpoint was best overall response; safety, biomarkers, pharmacokinetics, and other efficacy endpoints were also assessed. RESULTS: In part I/run-in, 75 BRAFi/MEKi-naïve patients and 83 BRAFi/MEKi-pretreated patients were treated; in part II, 58 patients were treated (ribociclib, n = 38; infigratinib, n = 1; capmatinib, n = 13; buparlisib, n = 6). The overall confirmed response rate was 73.3% [95% confidence interval (CI), 61.9-82.9] in BRAFi/MEKi-naïve patients, 25.3% (95% CI, 16.4-36.0) in pretreated patients, 2.6% (95% CI, 0.1-13.8) in the ribociclib arm, and 0% in the other three arms. Adverse events were manageable and consistent with the known safety profile of each drug. CONCLUSIONS: LOGIC 2 supports the use of encorafenib plus binimetinib for treatment-naïve and previously treated, locally advanced, unresectable or metastatic BRAFV600-mutant melanoma. However, adding a third targeted agent following disease progression did not show meaningful efficacy; further research is needed to identify other therapeutic targets to circumvent resistance.
Publisher: American Association for Cancer Research
Keywords: Humans; *Proto-Oncogene Proteins B-raf/genetics/antagonists & inhibitors; *Melanoma/genetics/drug therapy/pathology/mortality; Female; Male; Middle Aged; Aged; *Mutation; *Antineoplastic Combined Chemotherapy Protocols/therapeutic use/adverse effects; Benzimidazoles/administration & dosage; Adult; Sulfonamides/administration & dosage; Carbamates/administration & dosage; Protein Kinase Inhibitors/administration & dosage; Molecular Targeted Therapy; Biomarkers, Tumor/genetics; Genomics/methods; Aged, 80 and over
Department(s): Medical Oncology
Publisher's Version: https://doi.org/10.1158/1078-0432.Ccr-24-0254
Open Access at Publisher's Site: https://doi.org/10.1158/1078-0432.Ccr-24-0254
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2025-04-02 06:41:03

Last Modified: 2025-07-22 06:23:50