Can binimetinib, encorafenib and masitinib be more efficacious than currently available mutation-based targeted therapies for melanoma treatment?

ABSTRACT

Introduction: Historically, there were few effective and durable treatments for metastatic melanoma. Recently, mutation based targeted therapies have revolutionized treatment and outcomes for patients with metastatic melanoma. Specifically, inhibitors aimed at BRAF, NRAS, and C-KIT mutations are now commonly used in treatment for patients harboring the specific mutations.

Areas covered: A brief review of current BRAF, NRAS, and C-KIT inhibitors provides background for a thorough review of newly developed agents namely binimetinib, a MEK inhibitor, encorafenib a BRAF inhibitor, and masitinib which inhibits C-KIT.

Expert opinion: While the 3 novel agents reviewed here have potential for use in melanoma, optimal utilization will occur once a more personalized approach incorporating genomic, proteomic, and immunologic data guides therapeutic decisions.

KEYWORDS:

• Melanoma
• targeted therapy
• BRAF
• MEK
• c-kit

Article highlights

• Review current use of mutation based targeted therapies for BRAF, NRAS, and C-KIT mutant melanoma.

• Review mechanisms of resistance to targeted therapies and rational drug combinations.

• Examine 3 novel agents Encorafenib, a BRAF inhibitor, Binimetinib, a MEK inhibitor, and Masitinib, a C-KIT inhibitor from their unique pharmacokinetic properties to their use in current clinical trials.

• Discuss role of mutation based targeted therapy in the future of melanoma therapy.

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Declaration of interest

AKS Salama has received research funding (paid to institution) from Bristol-Myers Squibb, Celldex, Genentech, Immunocore and Reata and has been a consultant for Bristol-Myers Squibb. D Tyler has received research funding (paid to institution) from Bristol-Myers Squibb. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Additional information

Funding

This paper was not funded.