Melanoma — SCE Dermatology MCQ

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EasySkin CancerMelanomaSCE Dermatology

A 48-year-old man with advanced melanoma has a BRAF V600E mutation detected on molecular testing. Before starting targeted therapy, his dermatologist explains the significance. What proportion of cutaneous melanomas harbour BRAF mutations?

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Correct answer: D — Approximately 40-50%

Approximately 40-50% of cutaneous melanomas harbour activating BRAF mutations, with V600E being the most common (approximately 90% of BRAF mutations). V600K is the second most common. BRAF mutations are more common in younger patients, truncal melanomas, and those arising in intermittently sun-exposed skin. BRAF testing is mandatory for all unresectable stage III and stage IV melanomas to guide targeted therapy decisions (Dabrafenib/Trametinib or Encorafenib/Binimetinib). BRAF testing is also performed for resected stage III melanoma to determine eligibility for adjuvant BRAF/MEK therapy. Uveal melanoma characteristically has GNAQ/GNA11 mutations (not BRAF).

Reference: BAD 2017 Melanoma Guidelines; NICE NG14