WCCS/EADO 2016 | Rare mutation subgroups in melanoma and how to treat them

Dirk Schadendorf, MD of University Hospital Essen, Essen, Germany gives an overview of his talk on kinase inhibitors for rare mutation subgroups of melanoma 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. According to Prof. Schadendorf, treatment possibilities for patients with a BRAF mutation are good; with BRAF inhibitors and the combination of BRAF and MEK inhibition patients have a prolonged overall survival (OS) benefit. Treatment with MEK inhibitor in NRAS mutated patients shows minimal benefit, as shown in the NEMO trial (NCT01763164). He further discusses the question of how to treat patients with other mutations such as non-V600 mutations, some of which are sensitive to MEK inhibition. Further, NF1 mutations are also sensitive to MEK inhibitors but a clinical trial with a wider cohort of patients is needed. Further, he talks about c-KIT mutations, which could be sensitive to imatinib or nilotinib as seen in case reports. However, according to Prof. Schadendorf, a larger clinical trial with nilotinib did not show positive results but it is worthwhile to test such inhibitors in case checkpoint blockade is not working.