atezolizumab plus cometinib (n=222) vs. pembrolizumab alone (n=224)
randomized controlled trial
cometinib plus atezolizumab
cobimetinib (60 mg once daily, days 1-21) plus intravenous atezolizumab (840 mg, days 1 plus 15) in 28-day cycles
pembrolizumab
intravenous pembrolizumab (200 mg every 3 weeks)
Dose reductions for atezolizumab or pembrolizumab were not permitted.
mML - L1 - BRAF wild
open label
multicenter
P3/ two sided and no interim analysis. Hierarchical testing procedure (PFS(IRC) then OS then ORR)
Cobimetinib plus atezolizumab did not improve PFS compared with pembrolizumab monotherapy in patients with BRAF mutation
CheckMate 066, 2015 NCT01721772
nivolumab alone (n=210) vs. dacarbazine (n=208)
randomized controlled trial
nivolumab
Nivolumab at a dose of 3 mg per kilogram of body weight every 2 weeks, plus a dacarbazine-matched placebo every 3 weeks
dacarbazine
1000 mg of dacarbazine per square meter of body-surface area every 3 weeks, plus a nivolumab-matched placebo every 2 weeks.
Treatment continued until there was disease progression, as assessed by the investigator, or an unacceptable level of toxic effects. As a result, the monitoring committee recommended that the study be unblinded and amended to allow patients enrolled in the dacarbazine group to receive nivolumab.
mML - L1 - BRAF wild
exclusion criteria were active brain metastases, ans patients who had received adjuvant therapy previously were not excluded.
double-blind
Europe, Israel, Australia, Canada, and South America
P3/ two sided test procedure with interim analysis. Hierarchy OS then PFS then ORR
Nivolumab was associated with significant improvements in overall survival and progression-free survival, as compared with dacarbazine, among previously untreated patients who had metastatic melanoma without a BRAF mutation