Elderly Patient'S Tolerance And Efficacy For Map-Kinase Inhibitors In A French Melanoma Real-Life Cohort.

e21536 Background: Melanoma’s incidence is increasing, and elderly people could be significantly impacted since more than 50% of melanoma arise in > 65 years-old (yo). Combined BRAF and MEK targeted therapies (TT) are current standard regimen for BRAF V600 mutated metastatic melanoma (MM) since they overturned its prognostic. Except for subgroups of pivotal trials, little data are available for TT in this population. Methods: Outcomes were explored in real life patients from MelBase, a French multicentric biobank dedicated to the prospective follow-up of unresectable stage III or IV melanoma. Patients treated by BRAF TT (dabrafenib, vemurafenib) and/or MEK TT (cobimetinib, trametinib), combined or not, were included from 2012 to 2017 in 3 groups: group 1 < 65 yo, group 2 between 65 and 75, and group 3 > 75, analyzed for tolerance and efficacy. Results: 353 patients were included: 231(65%) in group 1, 72 (20%) in group 2 and 50 (14%) in group 3. Median follow-up was 12 months (M). Median time of treatment was 6.9M. 80% had at least one Adverse Effects (AE). In all groups, most frequent AE (all grades) were mainly skin and subcutaneous, general and gastrointestinal disorders. 31% of AE were grade 3-4: 28% in group 1 and 3 but 46% in group 2 (p = 0.05). In all groups, no differences were observed in all AE grades proportion, dose modifications, interruptions and discontinuations. For each group, median overall survival was 20.1M (CI 95%: 15.5-27.9), 16.4M (11.3-30.2) and 16.3M (13.6-NR) respectively (p = 0.8). Median progression free survival was 7.8M (6.4-9.95), 6.5M (5.4-10.94), 11.5M (6.1-15.11) respectively (p = 0.4). Response rate was 59%, 51%, and 48% respectively (p = 0.6). In multivariate analysis, stage M1a/b and high LDH level at TT initiation were significantly predictive of poorer tolerance in whole population as well as ECOG > 0 in group 3 (p = 0.05). Conclusions: This study on a large multicentric cohort is the first to assess that TT is well tolerated in elderly BRAF-mutated patients such as in patients < 65yo. Efficacy was similar between groups with outcomes reaching those from pivotal studies. There is thus no argument against using TT in elderly people, but onco-geriatric opinion is steel needed for patients over 75yo.