Treatment of Unresectable or Metastatic Cutaneous Melanoma Without BRAF V600 Mutation (BRAF Wild-Type)
This protocol addresses patients with unresectable and/or metastatic cutaneous melanoma whose tumours have been confirmed to carry no BRAF V600 mutation — the BRAF wild-type subgroup. Establishing this molecular distinction is central to guiding the treatment pathway in advanced disease.
Clinical Scenario
Patients with unresectable and/or metastatic cutaneous melanoma confirmed as BRAF wild-type (no BRAF V600 mutation). Molecular profiling demonstrating the absence of a BRAF V600 alteration defines eligibility for this specific treatment pathway.
Treatment Approach (Partial Summary)
Treatment in this setting may involve an ipilimumab-based immunotherapy regimen. The complete protocol — including regimen selection, sequencing guidance, and all relevant clinical considerations — is available via the structured evidence-based pathway below.
References
- For patients with BRAF wild-type, unresectable and/or metastatic cutaneous melanoma, the following treatment options should be offered (in no particular order): nivolumab plus ipilimumab followed by nivolumab OR nivolumab plus relatlimab OR nivolumab OR pembrolizumab.
- After progression on anti–PD-1–based therapy, patients with unresectable and/or metastatic BRAF wild-type cutaneous melanoma may be offered ipilimumab or ipilimumab-containing regimens.
- It should be noted that ipilimumab at 3 mg/kg once every 3 weeks for up to four doses has been approved by the US FDA in these patients on the basis of the trial by Hodi et al.
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