Cobimetinib, as a MEK1/2 inhibitor, has significant therapeutic effects on BRAFV600 mutation positive unresectable or metastatic melanoma. Its clinical efficacy has been validated through multiple studies, mainly manifested in prolonging progression free survival, improving objective response rates, and delaying drug resistance.

1 Clinical efficacy data

(1) Effective rate of combination therapy: When used in combination with vefipronil, the objective remission rate reached 68%, and the median progression free survival was 12.3 months, significantly better than monotherapy.

(2) Survival improvement: Phase III clinical trials have shown that the combination therapy reduces the risk of disease progression by 49% and the risk of death by 37%.

(3) Persistent response: Approximately 10% of patients achieve complete remission, with a median duration of remission of 13 months.

2. Effectiveness of mechanism of action

(1) Pathway inhibition: By effectively inhibiting the MAPK signaling pathway through blocking MEK1/2, BRAF mutant tumor cell proliferation is reduced by over 80%.

(2) Drug resistance management: Dual inhibition of BRAF and MEK can reduce the incidence of acquired drug resistance by 60%.

(3) Immune regulation: Reduce the levels of immunosuppressive factors in the tumor microenvironment, increasing CD8+T cell infiltration by 3-5 times.

3 Special Population Effects

(1) Patients with brain metastases: The control rate of intracranial lesions can reach 40%, which is better than traditional chemotherapy regimens.

(2) Elderly patients: The therapeutic effect of patients aged 65 and above is comparable to that of young patients, and there is no significant difference in safety.

(3) Abnormal liver function: Patients with mild damage do not need to adjust the dosage and can still maintain effective blood drug concentration.

4 Taboos for Special Groups

(1) Pregnancy period: Animal studies have shown embryotoxicity, and women of childbearing age need to use contraception for 2 weeks after discontinuing the medication.

(2) Breastfeeding period: Medication may be secreted into breast milk. Breastfeeding is prohibited during treatment and for one week after discontinuation of medication.

(3) Children: The safety and efficacy of patients under 18 years old have not been established.