Patients with advanced or metastatic mucosal melanoma whose tumours lack BRAF, KIT, or NRAS mutations represent a distinct clinical population in whom targeted therapies directed at those alterations are not applicable, requiring a separate treatment strategy.

Clinical scenario

Advanced, unresectable, or metastatic mucosal melanoma confirmed without BRAF, KIT, or NRAS mutation. Evidence suggests that chemotherapy combined with antiangiogenic agents may be viable in this unresectable or advanced setting.

Treatment approach (partial overview)

Immunotherapy — including pembrolizumab — is among the approaches evaluated in this population. Additional treatment options exist within this protocol.

Full agent selection, sequencing, and eligibility criteria are available in the structured protocol below.

References

DOI: 10.1200/EDBK-25-473858

The KEYNOTE-151 study reported pembrolizumab’s latest 3-year follow-up results as a second-line treatment for advanced melanoma.
A Chinese retrospective study presented at the 2018 European Society for Medical Oncology Congress reported a PFS of 4 months for ﬁrst-line therapy (dacarbazine 1 cisplatin 1 endostar) and 2 months for second-line treatment (paclitaxel 1 carboplatin 1 bevacizumab).
These ﬁndings suggest that chemotherapy combined with antiangiogenic agents may be viable for unresectable or advanced MM.

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Treatment of Advanced, Unresectable, or Metastatic Mucosal Melanoma Without BRAF, KIT, or NRAS Mutation

Clinical scenario

Treatment approach (partial overview)

References