The randomized phase 3 DREAMseq (EA6134) trial involving 265 people with advanced melanoma showed that if there was disease progression, starting treatment with combination PD-1/CTLA-4 immunotherapy (nivolumab and ipilimumab), followed by targeted BRAF/MEK therapy (dabrafenib and trametinib) led to a clinically meaningful 20% improvement in 2-year overall survival from the start of treatment when compared to the opposite treatment sequence (72% vs. 52%, respectively). Progression-free survival, where the cancer is stable or improving, was also trending in favor of those who started on immunotherapy.

DREAMseq was led by Michael Atkins, MD, deputy director of Georgetown Lombardi Comprehensive Cancer Center, on behalf of the ECOG-ACRIN Cancer Research Group and sponsored by the National Cancer Institute.