Focus on the dabrafenib, vemurafenib, and trametinib in clinical outcome of melanoma: a systematic review and meta-analysis

Ida Ayu Widya Anjani , Anak Agung Bagus Putra Indrakusuma, I Gede Krisna Arim Sadeva, Putri Ayu Wulandari, Luh Made Mas Rusyati, Prima Sanjiwani Saraswati Sudarsa, I Gede Putu Supadmanaba, Desak Made Wihandani

Ida Ayu Widya Anjani
Udayana Univesity. Email:

Anak Agung Bagus Putra Indrakusuma

I Gede Krisna Arim Sadeva

Putri Ayu Wulandari

Luh Made Mas Rusyati

Prima Sanjiwani Saraswati Sudarsa

I Gede Putu Supadmanaba

Desak Made Wihandani

Online First: December 15, 2020 | Cite this Article
Widya Anjani, I., Indrakusuma, A., Arim Sadeva, I., Wulandari, P., Rusyati, L., Sudarsa, P., Supadmanaba, I., Wihandani, D. 2020. Focus on the dabrafenib, vemurafenib, and trametinib in clinical outcome of melanoma: a systematic review and meta-analysis. Bali Dermatology and Venereology Journal 3(2). DOI:10.15562/bdv.v3i2.38

Background: Melanoma is the most serious lethal skin cancer, affects the melanin producer cells (melanocytes). Surgery is the most common treatment, whereas for the advance stage the development of a treatment is recommended. BRAF (Dabrafenib and Vemurafenib) inhibitor or MEK inhibitor (Trametinib) is used as the most frequently targeted therapy of melanoma due to more than 80% patient with positive BRAF mutation. In this review, those treatments will be investigated systematically to identify their clinical outcome.

Method: This systematic literature review (SLR) was performed from Cochrane, Science Direct, Google Scholar, and Pubmed. Cochrane Risk-of-Bias Tool RoB2 is used to assess RCT studies and New-castle Ottawa Scale Assessment to assess cohort studies by 3 different assessors. Data analysis was carried out by using Review Manager (RevMan 5.4). Heterogenicity test was assessed by I2  and Chi2 statistic

Result: There are 20 studies used in this article (13 RCT and 7 cohorts). The overall survival (OS) and progression-free survival (PFS) of study that using targeted therapy (vemurafenib, trametinib, or dabrafenib) compare other therapies (chemotherapy, immunotherapy,etc) showed risk ratio (RR) was 1.12 (95%CI 1.07,1.17;  I2=100%; p<0,00001). The OS and PFS with monotherapy compare of vemurafenib, trametinib, or dabrafenib with combination therapy showed RR was 1.09 (95%CI.06,1.13;I2=99%; p<0,00001).

Conclusion: BRAF and MEK targeted therapy has a good prognosis for a patient with a positive BRAF gene mutation and could be combined with other therapy for a better clinical outcome rather than monotherapy.

Keyword: melanoma, dabrafenib, vemurafenib, and trametinib


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