BRAF V600E Mutation is Prognostic Indicator for Cutaneous Melanoma

BRAF mutation was found to have a favorable prognostic effect on disease-free and overall survival (OS) in patients with melanoma except local disease, according to study findings published in Dermatologic Therapy.

In the study, researchers aimed to assess the prognostic significance of BRAF V600E mutation in cancer development and understand its association with clinicopathologic features in patients with cutaneous melanoma. A total of 151 adult patients with primary cutaneous melanoma (median age, 50 years; 69.5% men) with a mutated BRAF V600E status were included in the retrospective study in a single tertiary referral center in Turkey. Of the patients, 47.7% had regional disease (Stage III), 37.1% had local disease (Stage 1-II), and 15.2% had metastatic disease (Stage IV) at initial diagnosis. BRAF V600 mutation was detected using real-time PCR (qRT-PCR). Statistical analyses were performed to compare patient/disease variables and BRAF V600E mutation status, to estimate survival and differences in survival, and to determine disease-free survival (DFS) and OS.

BRAF V600E mutation was detected in the lesions of 51% of the patients. BRAF V600E mutation was shown to be higher in patients age <50 than in the elderly (61.4% vs 42%, respectively, P =.01). In addition, upper limbs (63.2%), trunk (59.3%), and head and neck (59.2%) were the most frequently affected sites in patients with BRAF-mutation, while lower limbs were mostly affected in BRAF-wild patients. There was no association between BRAF mutation status and major clinicopathologic features such as ulceration, mitotic rate, tumor thickness, or stage in patients with melanoma. However, BRAF mutation was shown to have a favorable prognostic influence on DFS and OS. DFS in regional disease was longer in the BRAF-mutation group than in the BRAF-wild group (P =.006 and P =.004, respectively), yet there were no survival differences in BRAF status for patients who had local disease. In a similar fashion, patients with BRAD-mutation had longer OS time compared with BRAF-wild patients for regional disease (P =.01) and metastatic disease (P =.01) but not for local disease.

Study limitations included the small sample size, specifically the small sample size of patients with metastatic disease.

The investigators concluded that in their research, BRAF V600E-mutant melanomas were “found to have a favorable prognostic impact on disease-free and OS in melanoma patients except Stage I-II” and that its prognostic value in patients with Stage IV melanoma has yet to be determined

Reference

Tas F, Erturk K. BRAF V600E mutation as a prognostic factor in cutaneous melanoma patients [published online February 4, 2020]. Dermatologic Therapy. doi: 10.1111/dth.13270