{"entity":{"id":"paper-combi-ad-nejm-2017","kind":"paper","name":"COMBI-AD: adjuvant dabrafenib plus trametinib in stage III BRAF-mutated melanoma","aka":[],"tldr":"A year of dabrafenib plus trametinib after surgery for stage III BRAF-mutant melanoma cut the risk of relapse by more than half, giving patients with BRAF mutations a targeted alternative to adjuvant immunotherapy.","summary":"Phase 3 placebo-controlled trial of 870 patients with completely resected stage III BRAF V600E or V600K melanoma randomised to 12 months of dabrafenib plus trametinib or placebo.\n\nThree-year relapse-free survival was 58 versus 39 percent (hazard ratio 0.47) with an early overall survival benefit (hazard ratio 0.57); five-year relapse-free survival was 52 versus 36 percent. Pyrexia and fatigue led to discontinuation in about a quarter.","asOf":"2026-09-17","links":[{"label":"N Engl J Med 2017","url":"https://doi.org/10.1056/NEJMoa1708539"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/28891408/"}],"tags":[],"related":[],"cancers":["braf-v600-melanoma","stage-iii-melanoma"],"sections":[],"technologies":[],"targets":[],"drugs":["dabrafenib","trametinib"],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":["combi-ad"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":["nejm"],"dependsOn":[],"notes":[],"journal":"New England Journal of Medicine","year":2017,"doi":"10.1056/NEJMoa1708539","pmid":"28891408","authors":"Long GV, Hauschild A, Santinami M, et al.","paperType":"rct","findings":["Three-year relapse-free survival 58 percent vs 39 percent; hazard ratio 0.47.","Five-year relapse-free survival 52 percent vs 36 percent."],"whatItMeans":"Adjuvant dabrafenib-trametinib is a standard for resected stage III BRAF-mutant melanoma alongside adjuvant PD-1 blockade; the choice weighs a finite year of oral therapy against immune side effects.","caveats":["Final overall survival analysis pending.","Discontinuation for adverse events in 26 percent."],"changedPractice":true,"participants":870},"route":"/key-papers/paper-combi-ad-nejm-2017/","neighbours":{"cancer":[{"id":"braf-v600-melanoma","kind":"cancer","name":"BRAF V600-mutant melanoma","route":"/cancers/braf-v600-melanoma/"},{"id":"stage-iii-melanoma","kind":"cancer","name":"Stage III melanoma (after surgery)","route":"/cancers/stage-iii-melanoma/"}],"drug":[{"id":"dabrafenib","kind":"drug","name":"Dabrafenib","route":"/drugs/dabrafenib/"},{"id":"trametinib","kind":"drug","name":"Trametinib","route":"/drugs/trametinib/"}],"trial":[{"id":"combi-ad","kind":"trial","name":"COMBI-AD","route":"/trials/combi-ad/"}],"journal":[{"id":"nejm","kind":"journal","name":"New England Journal of Medicine","route":"/journals/nejm/"}]}}