Melanoma — SCE Medical Oncology MCQ

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HardMelanoma & SkinMelanomaSCE Medical Oncology

A patient with rapidly progressive unresectable melanoma has a BRAF V600K mutation. Immunotherapy is judged unlikely to control the disease quickly enough. Which BRAF-directed regimen is a NICE option?

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Correct answer: E — Dabrafenib plus trametinib

Explanation lettering: D = shown as B · E = shown as C · C = shown as D · B = shown as E

B is correct. BRAF V600K is covered by the BRAF V600 indication for dabrafenib plus trametinib. Combined BRAF and MEK inhibition delays MAPK-pathway reactivation and improves outcomes compared with single-agent BRAF inhibition. Vemurafenib and dabrafenib monotherapy are fallbacks when combination partners are unsuitable rather than the selected combination here. Trametinib alone is less active, and adding trametinib to dacarbazine is not the licensed targeted regimen. The rapid progression makes a fast-acting targeted approach clinically coherent while retaining subsequent treatment planning.

Reference: NICE TA396 dabrafenib with trametinib recommendations: https://www.nice.org.uk/guidance/ta396/chapter/1-Recommendations