Melanoma
ICD-10 C43 ICD-11 2C30

Treatment of Resected Stage IIIA–D Cutaneous Melanoma with BRAF V600E/K Mutation

Clinical Scenario

This protocol applies to patients who have undergone complete surgical resection of stage IIIA–D cutaneous melanoma and whose tumour harbours a BRAF V600E or V600K mutation. The confirmed BRAF mutation status is a key factor in determining which adjuvant therapy pathways are available after surgery.

Adjuvant Therapy Approach

Guidelines recommend adjuvant systemic therapy for this population, with evidence-based options drawn from both immune checkpoint blockade and BRAF-targeted combination therapy. Multiple regimens have been studied and are offered to eligible patients. The full protocol details — including preferred options, eligibility criteria, and complete guidance — are available in the structured regimen…

Instant Access to Structured Evidence-Based Regimens

References

  1. 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 × 52 weeks OR pembrolizumab × 52 weeks OR dabrafenib plus trametinib × 52 weeks.
  2. Pembrolizumab 200 mg iv once every 3 weeks for 52 weeks (EORTC 13259)
  3. 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)
  4. Dabrafenib 150 mg orally twice daily plus trametinib 2 mg orally once daily for 52 weeks (COMBI-AD11)
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