Treatment of Amelanocytic Melanoma in Resected Stage IIIA–D Cutaneous Melanoma with BRAF Mutation (V600E/K)

This protocol addresses the post-surgical adjuvant setting for patients with completely resected stage IIIA–D cutaneous amelanocytic melanoma whose tumour harbours a BRAF V600E or V600K mutation — a specific subgroup for which distinct systemic adjuvant options are indicated.

Clinical scenario

Resected stage IIIA–D cutaneous melanoma with confirmed BRAF-mutant (V600E/K) status. Following complete resection, adjuvant systemic therapy is recommended, with multiple evidence-based options available to offer in this BRAF-mutant population.

Treatment approach (partial overview)

Adjuvant systemic therapy is indicated, with evidence-based options spanning more than one class of agent — each given over a defined course. Which regimen is appropriate depends on individual patient and disease factors. The full protocol presents all recommended options and the basis for selection.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1200/JCO.23.01136

For patients with resected stage IIIA-D disease that is BRAF-mutant (V600E/K*), the following adjuvant therapy options should be offered (in no particular order): nivolumab 3 52 weeks OR pembrolizumab 3 52 weeks OR dabrafenib plus trametinib 3 52 weeks.
Nivolumab 240 mg iv once every 2 weeks or once 480 mg iv once every 4 weeks for 52 weeks (CheckMate 23810 and US FDA label)
Pembrolizumab 200 mg iv once every 3 weeks for 52 weeks (EORTC 13259)
Dabrafenib 150 mg orally twice daily plus trametinib 2 mg orally once daily for 52 weeks (COMBI-AD11)

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