Dr. Sullivan on Treatment Options in BRAF-Mutant Melanoma

Ryan Sullivan, MD, medical oncologist, attending physician, Division of Hematology/Oncology, Massachusetts General Hospital, discusses treatment options in BRAF-mutant melanoma.

Patients with melanoma who harbor a BRAF mutation are eligible to receive combination BRAF/MEK inhibitor therapy, ipilimumab (Yervoy) in combination with nivolumab (Opdivo), or single-agent checkpoint inhibitor therapy with nivolumab or pembrolizumab (Keytruda) in the frontline setting, says Sullivan. However, BRAF-targeted therapy is not appropriate for patients without BRAF mutations.

Single-agent nivolumab and pembrolizumab, as well as the BRAF/MEK inhibitor combination of dabrafenib (Tafinlar) and trametinib (Mekinist) are approved for use in the adjuvant setting for patients with BRAF-mutant disease, Sullivan explains. Although the tendency is to offer immunotherapy up front to patients with metastatic melanoma, it may be preferable to offer patients with BRAF mutations BRAF-targeted therapy rather than checkpoint inhibitors in the adjuvant space, concludes Sullivan.