Fast Five Quiz: Are You Able to Identify and Treat Melanomas?

Winston Tan, MD


June 02, 2015

BRAF mutations are present in 40%-60% of melanomas. Detection of this mutation can help to guide treatment. In a multicenter, phase 1, dose-escalation trial, 32 patients with metastatic melanoma who had a BRAF mutation were treated with vemurafenib. Two patients had a complete response and 24 had a partial response.

Vemurafenib (Zelboraf®) was approved by the US Food and Drug Association in August 2011. It is an inhibitor of some mutated forms of BRAF serine-threonine kinase, including BRAF V600E. The drug is indicated for the treatment of unresectable or metastatic melanoma with BRAF V600 mutation as detected by the cobas® 4800 BRAF V600 Mutation Test (Roche Molecular Systems). Vemurafenib has not been studied in wild-type BRAF melanoma.

Phase 3 trial results for the investigational BRAF inhibitor vemurafenib included a 63% relative reduction in the risk for death as well as a 74% relative reduction in the risk for tumor progression in patients with previously untreated metastatic melanoma with the BRAF V600E mutation, compared with dacarbazine. In addition, the overall survival rate at 6 months in the vemurafenib group was 84% vs 64% in the dacarbazine group. Despite the short follow-up period, these results have significant clinical implications, because of the previously mentioned 40%-60% of cutaneous melanomas with BRAF mutations, about 90% involve the BRAF V600E mutation.

For more on the treatment of melanoma, read here.

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