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This Week in NEJM: Jun 9, 2011


In NEJM this week, researchers from the US, Europe, and Australia present findings from a study on the use of vemurafenib to improve survival in melanoma patients with a BRAF V600E mutation. The researchers conducted a Phase III randomized clinical trial comparing vemurafenib with dacarbazine in 675 patients with previously untreated, metastatic melanoma with the BRAF V600E mutation, and found that the patients receiving vemurafenib had an overall survival rate of 84 percent at six months, compared to the dacarbazine group which had a survival rate of 64 percent. Vemurafenib was also associated with a relative reduction of 63 percent in the risk of death and of 74 percent in the risk of either death or disease progression as compared to dacarbazine, the authors write.

Also in NEJM this week, researchers in the US and Canada present findings on the use of exemestane for breast cancer prevention in post-menopausal women. The researchers randomly assigned 4,560 women to receive either exemestane or placebo, and found that at a median follow-up of 35 months, 11 invasive breast cancers were detected in women taking exemestane, compared with 32 in the placebo group, with a 65 percent relative reduction in the annual incidence of invasive breast cancer in the intervention group. "Exemestane significantly reduced invasive breast cancers in postmenopausal women who were at moderately increased risk for breast cancer," the authors write. "During a median follow-up period of 3 years, exemestane was associated with no serious toxic effects and only minimal changes in health-related quality of life."

And finally in NEJM this week, an international team of researchers studies the efficacy of ipilimumab plus dacarbazine to treat metastatic melanoma. The researchers assigned 502 patients with previously untreated metastatic melanoma to receive either dacarbazine with ipilimumab, or dacarbazine with placebo, and found that overall survival was significantly longer in the combination therapy group, though there were a greater number of adverse events in the combination therapy group than in the dacarbazine and placebo group.

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