Treatment of patients with advanced melanoma harboring the BRAF V600 mutation

The advances in the treatment of melanoma patients with V600 mutations in the BRAF gene over the past few years result from the introduction of targeted drugs and modern immunotherapy. Unfortunately, at the moment there is a lack of data from a randomised clinical trial that determines the optimal sequence of anti-BRAF/anti-MEK drugs and immunotherapy in BRAF (+) patients. This paper discusses the most important clinical trials performed so far, the results of which may be helpful in the selection of systemic treatment in patients with advanced or metastatic melanoma harbouring BRAF V600 mutation. Formal analysis indicates that molecularly targeted treatment is the method of choice in the first-line setting in patients with BRAF (+) melanoma because the value of anti-BRAF/anti-MEK drugs in this population was confirmed by consistent results of three phase 3 studies. Conversely, evidence for the effectiveness of immunotherapy in advanced BRAF (+) melanoma are much weaker. However, both methods significantly improved the prognosis, and in some patients with BRAF gene mutation they led to long-term survival. Currently, the research is ongoing, and the results may resolve this issue.