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

Prognostic factors in melanoma

In metastatic melanoma, the overall prognosis is poor.1 Although less common, melanomas are considered more deadly than other non-melanoma skin cancers due to its ability to metastasise.2

Prognostic factors

Many factors can affect the prognosis of melanoma. Prognostic factors include BRAF and NRAS genetic mutations, tumour and disease characteristics, and patient factors (see figure).1,3-7

Genetic mutations, such as BRAF and NRAS mutations, have been widely studied in relation to prognosis, with several studies supporting their role as a potential prognostic factor.1,3-7 The next sections will discuss the relationship between BRAF mutation and other prognostic factors, including tumour and patient characteristics.

Prognostic factors in melanoma

Negative prognostic factors in metastatic disease include1:

  • Increased lymph node involvement
  • Increased tumour burden
  • Anatomical site of disease (eg, brain, lung)
  • Increased serum lactate dehydrogenase (LDH) levels

In localised disease, the following characteristics are negative prognostic factors1:

  • Increased tumour thickness
  • Elevated mitotic rate
  • Increased ulceration
  1. Balch CM, et al. Final version of 2009 AJCC melanoma staging and classification J Clin Oncol. 2009;27(36):6199-206.
  2. National Cancer Institute. What you need to know aboutTM melanoma and other skin cancers. http://www.cancer.gov/publications/patient-education/skin.pdf. Accessed August 3, 2016.
  3. 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.
  4. Houben R, et al. Constitutive activation of the Ras-Raf signaling pathway in metastatic melanoma is associated with poor prognosis. J Carcinog. 2004;3(1):6.
  5. National Cancer Institute. SEER stat fact sheets: melanoma of the skin. http://seer.cancer.gov/statfacts/html/melan.html. Accessed August 3, 2016.
  6. Jang RW, et al. Simple prognostic model for patients with advanced cancer based on performance status. J Oncol Pract. 2014;10(5):e335-41.
  7. Davies MA, et al. Prognostic factors for survival in melanoma patients with brain metastases. Cancer. 2011;117(8):1687-96.
  8. Long GV, et al. Prognostic and clinicopathologic associations of oncogenic BRAF in metastatic melanoma. J Clin Oncol. 2011;29(10):1239-46.
  9. Jakob JA, et al. NRAS mutation status is an independent prognostic factor in metastatic melanoma. Cancer. 2012;118(16):4014-23.