Dr. Pavlick on Sequencing Challenges in BRAF-Mutant Melanoma Treatment

Anna C. Pavlick, DO, professor in the Department of Medicine and Ronald O. Perelman Department of Dermatology, as well as the director of High Reliability Organization Initiatives and the co-director of the Melanoma Program at NYU Langone Health’s Perlmutter Cancer Center, discusses sequencing challenges faced in the treatment of patients with BRAF-mutant melanoma.

Treatment decisions for patients with melanoma depend upon whether a genetic mutation is present, says Pavlick. Fifty percent of patients with metastatic melanoma harbor a BRAF mutation, for which there are targeted agents available, explains Pavlick. Patients with BRAF mutations can either receive targeted therapy or immunotherapy, and those without mutations are offered immunotherapy, according to Pavlick.

A current challenge when treating patients with BRAF-mutant melanoma is determining whether immunotherapy or targeted therapy should be administered first, says Pavlick. Immunotherapy will take some time to work; therefore, if a patient with a BRAF mutation is not doing well, they will likely receive targeted drugs first. Meanwhile, a patient with more indolent disease who looks and feels well will likely receive immunotherapy, concludes Pavlick.