BRAF Inhibitor Resistance in Melanoma: Mechanisms and Alternative Therapeutic Strategies

Curr Treat Options Oncol. 2022 Nov;23(11):1503-1521. doi: 10.1007/s11864-022-01006-7. Epub 2022 Oct 1.

Abstract

Melanoma is caused by a variety of somatic mutations, and among these mutations, BRAF mutation occurs most frequently and has routinely been evaluated as a critical diagnostic biomarker in clinical practice. The introduction of targeted agents for BRAF-mutant melanoma has significantly improved overall survival in a large proportion of patients. However, there is BRAF inhibitor resistance in most patients, and its mechanisms are complicated and need further clarification. Additionally, treatment approaches to overcome resistance have evolved rapidly, shifting from monotherapy to multimodality treatment, which has dramatically improved patient outcomes in clinical trials and practice. This review highlights the mechanisms of BRAF inhibitor resistance in melanoma and discusses the current state of its therapeutic approaches that can be further explored in clinical practice.

Keywords: BRAF inhibitor; BRAF mutation; Combination therapy; Melanoma; Resistance mechanism; Targeted therapy.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Biomarkers
  • Drug Resistance, Neoplasm / genetics
  • Humans
  • Melanoma* / etiology
  • Melanoma* / genetics
  • Mutation
  • Protein Kinase Inhibitors / pharmacology
  • Protein Kinase Inhibitors / therapeutic use
  • Proto-Oncogene Proteins B-raf* / genetics

Substances

  • Proto-Oncogene Proteins B-raf
  • Protein Kinase Inhibitors
  • Biomarkers
  • BRAF protein, human