Treating malignant melanoma when a rare BRAF V600M mutation is present: case report and literature review

Rom J Intern Med. 2018 Jun 1;56(2):122-126. doi: 10.1515/rjim-2017-0044.

Abstract

Recent years have brought major advances in the treatment of malignant melanoma. One such an advance is the treatment with BRAF tyrosine-kinase inhibitors in metastatic malignant melanomas that harbor mutations in the BRAF gene. The trials that have been performed in this setting have demonstrated superior response rates and increased overall survival, however, they mostly included patients with melanomas carrying the more common V600E and V600K mutations, not being able to assess the benefit of these treatments in situations where more rare mutations of the BRAF gene are present. We present the evolution of a patient with malignant melanoma with a rare V600M mutation in the BRAF gene, that was eventually treated with vemurafenib. Also we present a brief review of the major phase III trials that showed benefit with tyrosine-kinase inhibitors in BRAF mutated melanoma, with respect to the BRAF mutations included.

Keywords: cutaneous malignant; dabrafenib; melanoma; protein-tyrosine kinases; vemurafenib.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Dacarbazine / therapeutic use
  • Fatal Outcome
  • Humans
  • Interferons / therapeutic use
  • Male
  • Melanoma / diagnosis
  • Melanoma / drug therapy*
  • Melanoma / genetics*
  • Melanoma / pathology
  • Melanoma, Cutaneous Malignant
  • Middle Aged
  • Neoplasm Metastasis
  • Point Mutation*
  • Protein Kinase Inhibitors / therapeutic use*
  • Proto-Oncogene Proteins B-raf / genetics*
  • Skin Neoplasms / diagnosis
  • Skin Neoplasms / drug therapy*
  • Skin Neoplasms / genetics*
  • Skin Neoplasms / pathology
  • Vemurafenib / therapeutic use*

Substances

  • Protein Kinase Inhibitors
  • Vemurafenib
  • Dacarbazine
  • Interferons
  • BRAF protein, human
  • Proto-Oncogene Proteins B-raf