Summary

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• Cobimetinib (Cotellic) is indicated for the treatment of patients with unresectable or metastatic melanoma with a BRAF V600E or V600K mutation, in combination with vemurafenib. It is also used as a single agent to treat adult patients with histiocytic neoplasms.
• Ten studies were reviewed, comparing Cotellic (cobimetinib) in combination with other drugs versus various treatment regimens for BRAF V600-mutant unresectable or metastatic melanoma, focusing on safety and efficacy.
• The effectiveness comparison indicates that cobimetinib combined with vemurafenib has a less favorable profile when compared to encorafenib + binimetinib due to superior overall response rates and fewer serious adverse events reported by the latter.
• In terms of safety profile, cobimetinib + vemurafenib displays competitive safety but is outperformed by dabrafenib + trametinib, which showed fewer high-grade adverse events according to certain analyses.
• Subgroup considerations reveal prognostic factors such as baseline lactate dehydrogenase, disease stage, performance status at progression, and initial post-progression treatment are significant for post-progression survival, emphasizing tailored treatments based on patient-specific factors.
• Strategic sequencing of immunotherapy or targeted therapy significantly impacts survival outcomes, suggesting benefits of strategic treatment sequencing for advanced melanoma patients.