Survival analysis of early stage melanoma patients with BRAF mutations

The authors analyzed whether mutations (permanent changes) in BRAF genes in early stage melanoma can predict patient outcome. 

In skin melanoma, BRAF genes are often mutated. These genes are involved in cellular signaling and important protein function. This includes MAPK and MEK proteins. In melanoma with BRAF mutations, these proteins remain permanently active. This results in uncontrolled growth of cancer cells. BRAF inhibitors are drugs that stop cell signaling in these genes. They have been shown to improve overall survival in melanoma patients. It is not fully understood whether the presence of BRAF mutations can predict the outcome of patients diagnosed with early stage melanoma (stage I/II – cancer confined to the original site).

Further research is needed to understand if there is any correlation between the two.  

The authors aimed to determine if the presence of BRAF mutations in stage I/II melanoma patients could predict the outcome of the disease.

437 patients with stage I/II melanoma at initial diagnosis were included in this study. All patients had undergone surgery to remove tumors. The median (midpoint) follow-up was 93 months.

75% of patients younger than 30 years of age had BRAF mutations. 19% of patients aged 70 years or more had BRAF mutations. 379 patients were disease-free during follow-up. Of these, 36.7% had BRAF mutations. Overall, melanoma spread to distant parts of the body in 58 patients, of whom, 51.7% had BRAF mutations. 11.9% patients died from melanoma during follow-up.

There was no association between overall survival (patients who were still alive after treatment) and mutation status. 17.8% of patients with BRAF mutations progressed to an advanced stage (stage IV) of the disease. This was compared to 10.4% of patients without BRAF mutations.

Patients with BRAF mutations and with a tumor thickness (how far the cancer reached into the skin) of less than 1 mm were at a 11.6 times greater risk of dying from melanoma.

The authors concluded that overall survival was not associated with BRAF mutation status in melanoma patients. They further indicated that mutational status in patients with less than 1 mm tumor thickness affected overall survival.