How is it used?
In patients with melanoma, this test is primarily used in people with late stage metastatic disease, where the cancer cells have already spread widely, to determine suitability for BRAF-targeted therapy such as dabrafenib or vemurafenib. In patients with local early stage melanoma, surgical excision remains the treatment of choice and has a high likelihood of success if it is caught before metastases have travelled away from the primary tumour site.
When is it requested?
The test is requested predominantly in people whose melanoma has spread to other sites (metastatic melanoma) and who can no longer be treated with surgery alone.
Less commonly, this test may be used to guide the management of other non-melanoma cancers, such as thyroid, colorectal, non-small cell lung cancer and a type of blood cancer called hairy cell leukaemia.
What does the test result mean?
Around 40 – 60% of melanomas have a mutation at codon 600 and up to 90% of these are a specific mutation called V600E. The test determines whether there is a mutation at this site. BRAF inhibitor drugs such as dabrafenib or vemurafenib are only useful in people whose tumour does carry a BRAF V600 mutation.
Is there anything else I should know?
BRAF inhibitor drugs (often used in combination with MEK inhibitor drugs) bring about a response in most people with late stage melanoma disease, they reduce symptoms and disease progression for a variable period, generally less than a year.