New Treatment Paradigms for Advanced Melanoma - Episode 17

Molecular Testing in Stage 3 Melanoma


Merrick I. Ross, MD: When making decisions about adjuvant therapy for patients with high-risk melanoma, it’s important to look at the data related to the use of biomarkers to identify specific patients for certain therapies. Currently, the only test that’s really relevant for these patients is BRAF testing, and it has to be an FDA-approved test.

In terms of other biomarkers, particularly for immunotherapy, if we’re looking at PD-L1 testing, it’s probably not a great biomarker. In the trials, there didn’t really seem to be a difference, in terms of the efficacy of immunotherapy, particularly for the checkpoint blockade, when using anti—PD-1 therapy. There didn’t seem to be a difference in the outcome, whether the patients were PD-L1–positive or PD-L1–negative.

BRAF is a very important marker. Patients who don’t have that mutation will not benefit from targeted therapy—specifically the approved combination of the BRAF inhibitor and the MEK inhibitor. So, for patients who are eligible for adjuvant therapy, BRAF testing is mandated, particularly if you’re going to consider the BRAF/MEK-targeted combination.

Transcript Edited for Clarity