Current Controversies and Challenges on BRAF V600K-Mutant Cutaneous Melanoma.
Alessandro NepoteGianluca AvalloneSimone RiberoFrancesco CavalloGabriele RoccuzzoLuca MastorinoConforti ClaudioLuca ParuzzoStefano PolettoFabrizio Carnevale SchiancaPietro QuaglinoMassimo AgliettaPublished in: Journal of clinical medicine (2022)
About 50% of melanomas harbour a BRAF mutation. Of these 50%, 10% have a V600K mutation. Although it is the second most common driver mutation after V600E, no specific studies have been conducted to identify a clinical and therapeutic gold standard for this patient subgroup. We analysed articles, including registrative clinical trials, to identify common clinical and biological traits of the V600K melanoma population, including different adopted therapeutic strategies. Melanoma V600K seems to be more frequent in Caucasian, male and elderly populations with a history of chronic sun damage and exposure. Prognosis is poor and no specific prognostic factor has been identified. Recent findings have underlined how melanoma V600K seems to be less dependent on the ERK/MAPK pathway, with a higher expression of PI3KB and a strong inhibition of multiple antiapoptotic pathways. Both target therapy with BRAF inhibitors + MEK inhibitors and immunotherapy with anti-checkpoint blockades are effective in melanoma V600K, although no sufficient evidence can currently support a formal recommendation for first line treatment choice in IIIC unresectable/IV stage patients. Still, melanoma V600K represents an unmet medical need and a marker of poor prognosis for cutaneous melanoma.
Keyphrases
- poor prognosis
- prognostic factors
- skin cancer
- clinical trial
- signaling pathway
- basal cell carcinoma
- oxidative stress
- dna damage
- healthcare
- ejection fraction
- mesenchymal stem cells
- cell proliferation
- newly diagnosed
- squamous cell carcinoma
- metastatic colorectal cancer
- wild type
- bone marrow
- locally advanced
- middle aged
- study protocol
- open label
- patient reported