Treatment of Resected Stage IIIA–D Cutaneous Melanoma: BRAF Wild-Type (No BRAF V600 Mutation)
After complete resection of stage IIIA–D cutaneous melanoma, the presence or absence of a BRAF V600 mutation determines which adjuvant options are appropriate. In patients with BRAF wild-type tumours, targeted BRAF therapy is not applicable, and a distinct set of evidence-based adjuvant approaches applies.
Clinical Scenario
Resected stage IIIA–D cutaneous melanoma with confirmed BRAF wild-type status — that is, no detectable BRAF V600 mutation. This molecular profile defines the eligible population for the adjuvant options covered in this protocol.
Adjuvant Approach
Evidence-based guidelines recommend adjuvant immunotherapy in this setting. The specific agent options, dosing schedules, and treatment duration are detailed in the full structured protocol — access it below.
References
- For patients with resected stage IIIA-D disease that is BRAF wild-type, the following adjuvant therapy options should be offered (in no particular order): nivolumab × 52 weeks OR pembrolizumab × 52 weeks.
- Pembrolizumab 200 mg iv once every 3 weeks for 52 weeks (EORTC 13259)
- 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)