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BRAF mutation in localized melanomas meant poor prognosis

The presence of a BRAF mutation in patients with localized cutaneous melanomas indicated a poor prognosis, according to recent study results.

Researchers conducted a retrospective study of 147 patients (median age, 53 years; 46.3% men) with localized invasive (stage I and II) cutaneous melanomas who were registered in a Spanish database between January 2004 and May 2012. Ninety-two tumors (62.6%) presented on axial location; median tumor thickness was 1 mm. Prognostic value of BRAF mutation status was evaluated during a median follow-up of 49 months.

There were 38 patients (25.9%) with mutated BRAF and 27 (18.4%) with mutated NRAS, both mutually exclusive. After adjusting for Breslow thickness, ulceration, location, age, sex and tumor mitotic rate, patients with localized melanomas including BRAF-mutant melanomas exhibited poorer disease-free survival (DFS) than patients with BRAF-wild-type genotype (HR=2.2; 95% CI, 1.1-4.3). Mutant BRAF was not a prognostic factor for worse overall survival (OS; HR=1.5; 95% CI, 0.5-4.4).

The low number of events for OS and DFS analyses and the short follow-up were study limitations, according to the researchers.

“Although it is still premature, patients harboring tumors with BRAF mutation might benefit from adjuvant therapies,” the researchers concluded. “Currently, the only approved treatment, interferon, is toxic, and has little impact on OS. The impressive activity of BRAF inhibitors … provides hope that they may reduce the risk of recurrence and improve OS when given as an adjuvant. Results of ongoing trials evaluating these agents … are thus eagerly awaited.”

Disclosure: The researchers report no relevant financial disclosures.