Targeted therapies in melanoma beyond BRAF: targeting NRAS-mutated and KIT-mutated melanoma

Curr Opin Oncol. 2020 Mar;32(2):79-84. doi: 10.1097/CCO.0000000000000606.

Abstract

Purpose of review: Melanoma treatment have been revolutionized since 2010 by the development of immune checkpoint inhibitors, and, for BRAF-mutated melanoma, targeted therapies based on BRAF and MEK inhibitors, which is a model of effective targeted therapy in cancer. However, patients with BRAF wild type cannot benefit for such treatments. In this review, we will focus on the current clinical development of targeted therapies beyond BRAF, in NRAS-mutated and KIT-altered melanoma.

Recent findings: In NRAS-mutated melanoma, targeted therapies based on MEK inhibition are being developed as monotherapy or in combination with MAPK, PI3K or CDK4/6 inhibitor. Targeted therapies of KIT-altered melanoma patients is based in KIT inhibitor (mostly imatinib, nilotinib), although for both melanoma subtypes, results are for now disappointing as compared with BRAF and MEK inhibitors in BRAF-mutated melanoma.

Summary: Combined therapeutic targeted strategies are awaited in NRAS-mutated and KIT-altered melanoma and could provide additional benefit.

Publication types

  • Review

MeSH terms

  • Clinical Trials, Phase III as Topic
  • GTP Phosphohydrolases / antagonists & inhibitors*
  • GTP Phosphohydrolases / genetics
  • Humans
  • Melanoma / drug therapy*
  • Melanoma / enzymology
  • Melanoma / genetics
  • Membrane Proteins / antagonists & inhibitors*
  • Membrane Proteins / genetics
  • Molecular Targeted Therapy
  • Mutation
  • Protein Kinase Inhibitors / therapeutic use
  • Proto-Oncogene Proteins B-raf / antagonists & inhibitors*
  • Proto-Oncogene Proteins B-raf / genetics
  • Proto-Oncogene Proteins c-kit / antagonists & inhibitors*
  • Proto-Oncogene Proteins c-kit / genetics
  • Randomized Controlled Trials as Topic
  • Skin Neoplasms / drug therapy
  • Skin Neoplasms / enzymology
  • Skin Neoplasms / genetics

Substances

  • Membrane Proteins
  • Protein Kinase Inhibitors
  • KIT protein, human
  • Proto-Oncogene Proteins c-kit
  • BRAF protein, human
  • Proto-Oncogene Proteins B-raf
  • GTP Phosphohydrolases
  • NRAS protein, human