How best to treat NRAS-mutated melanoma

Jean-Jacques Grob, MD of the Aix-Marseille University and APHM Hospital CHU Timone, Marseille, France, discusses treatments for melanoma patients with NRAS mutation at the 2016 World Congress on Cancers of the Skin (WCCS) and the Congress of the European Association of Dermato-Oncology (EADO) in Vienna, Austria. Prof. Grob explains that NRAS-mutated patients represent 15-20% of melanoma patients and this subgroup of patients tends to have a poorer prognosis. Further, current treatments for melanoma, such as BRAF inhibitors, are not as effective for these patients. Prof. Grob gives the example of the MEK inhibitor (binimetinib); however the results are somewhat disappointing as even though disease-free survival (DFS) improved following treatmet, overall survival (OS) did not. Prof. Grob advocates that combination therapies should be trialled in this subgroup of patients with, for example, PI3 kinase inhibition, and other mutations that are associated with NRAS mutations combined with sequencing and immunotherapy.

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