BRAFm+ Metastatic melanoma
What makes it different, makes it vulnerable

Prognosis of BRAFm+ melanoma

BRAF mutation may be associated with a worse prognosis versus wild-type BRAF1-6

Multiple studies have examined the relationship between BRAF mutation and overall survival in patients with stage III and stage IV disease.1-6 In a prospective study of 197 metastatic melanoma patients, overall survival was significantly decreased in those with a BRAF mutation who had not received treatment compared with those patients with wild-type BRAF (see figure below).1

Prospective analysis of 197 untreated patients by BRAF mutation1

Adapted with permission from: Long GV et al. J Clin Oncol. 2011;29(10):1239-46.

 

Additional data from retrospective studies provide further support for decreased survival in patients with BRAF mutations.2 One such study included metastatic melanoma patients with BRAF (49%) or NRAS (21%) mutation, or no mutation (wild-type, 30%), and found a similar survival detriment associated with untreated patients who have a BRAF mutation.2

Retrospective analysis of metastatic melanoma patients by BRAF mutation2

Adapted with permission from: Jakob JA et al. Cancer. 2012;118(16):4014-23.

 

Recognising the difference in survival in patients with and without BRAF mutation suggests the activating mutation may make a patient more vulnerable to a worse prognosis. Thus, this highlights the importance of identifying BRAF mutations early in the disease to help inform treatment decisions.

 

  1. Long GV, et al. Prognostic and clinicopathologic associations of oncogenic BRAF in metastatic melanoma. J Clin Oncol. 2011;29(10):1239-46.
  2. Jakob JA, et al. NRAS mutation status is an independent prognostic factor in metastatic melanoma. Cancer. 2012;118(16):4014-23.
  3. Ugurel S, et al. B-RAF and N-RAS mutations are preserved during short time in vitro propagation and differentially impact prognosis. PLoS ONE. 2007;2(2):e236.
  4. Thomas NE, et al. Association between NRAS and BRAF mutational status and melanoma-specific survival among patients with higher-risk primary melanoma. JAMA Oncol. 2015;1(3):359-68.
  5. Hugdahl E, et al. BRAF-V600E expression in primary nodular melanoma is associated with aggressive tumour features and reduced survival. Br J Cancer. 2016;114(7):801-8.
  6. Jacquelot N, et al. Immunophenotyping of stage III melanoma reveals parameters associated with patient prognosis. J Invest Dermatol. 2016;136(5):994-1001.