Dr. Chandra on the Incidence of Targetable Mutations in Melanoma

Sunandana Chandra, MD, MS, assistant professor of medicine, Division of Hematology and Oncology, Northwestern University Feinberg School of Medicine, discusses the incidence of targetable mutations in melanoma.

The MAP kinase pathway is constitutively active in patients with melanoma, particularly for those with BRAF mutations, says Chandra. Moreover, inhibition of this pathway has shown improved outcomes for patients.

BRAF mutations occur in about half of all patients with melanoma, 90% of which are BRAF V600E mutations, explains Chandra. Other potentially actionable genomic mutations include NRAS and KIT, which are each present in around 20% of patients with melanoma. Notably, KIT alterations are often observed in mucosal melanoma and acral melanoma.

Although studies have evaluated MEK inhibitors in NRAS-mutant melanoma and TKIs such as imatinib (Gleevec) and dasatinib (Sprycel) in KIT­-mutant melanoma, responses have been modest, explains Chandra. Additional research is needed to elucidate which patients with NRAS and KIT mutations are best suited for targeted therapy, concludes Chandra.