BRAFV600 wild-type status tied to poorer survival in advanced melanoma

Survival is worse among patients with advanced BRAFV600 wild-type melanoma than those with BRAFV600-mutant advanced melanoma during the first 10 months following diagnosis due to limited treatment options, according to a Dutch study.

The investigators recruited patients aged ≥18 years, diagnosed between 2016 and 2017 with unresectable stage IIIC or IV melanoma, and registered in the Dutch Melanoma Treatment Registry. Cox proportional hazards model was used to assess the association of BRAFV600-mutation status with overall survival (OS).

The analysis included 642 and 853 BRAFV600 wild-type and mutant patients, respectively. No significant between-group difference was noted in median OS (15.2 months, 95 percent confidence interval [CI], 13.2–19.2 vs 20.6 months, 95 percent CI, 18.3–25.0).

Survival rates at 6 and 12 months were significantly lower for BRAFV600 wild-type patients (72.0 percent, 95 percent CI, 68.6–75.6 and 56.0 percent, 95 percent CI, 52.2–60.0, respectively) than for BRAFV600-mutant patients (83.4 percent, 95 percent CI, 80.9–85.9 and 65.7 percent, 95 percent CI, 62.6–69.0, respectively).

No significant between-group difference was observed in 2-year survival (41.1 percent, 95 percent CI, 37.2–45.3 vs 47.0 percent, 95 percent CI, 43.6–60.6).

BRAFV600 wild-type patients had a reduced survival between 0 and 10 months (hazard ratio, 2.00, 95 percent CI, 1.62–2.46), but this effect disappeared after 10 months. At 12 months, BRAFV600-mutant patients had initiated second-line systemic treatment more often than those with BRAFV600 wild-type melanoma (50 percent vs 19 percent).