Nationwide Outcomes of Advanced Melanoma According to BRAFV600Status

Jesper van Breeschoten, Michel W. J. M. Wouters, Liesbeth C. de Wreede, Doranne H. Hilarius, John B. Haanen, Christian U. Blank, Maureen J. B. Aarts, Franchette W. P. J. van den Berkmortel, Jan-Willem B. de Groot, Geke A. P. Hospers, Ellen Kapiteijn, Djura Piersma, Rozemarijn S. van Rijn, Karijn P. M. Suijkerbuijk, Willeke A. M. Blokx, Albert J. ten Tije, Astrid A. M. van der Veldt, Gerard Vreugdenhil, Marye J. Boers, Alfons J. M. van den Eertwegh

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Objective:The aim of this study was to evaluate treatment patterns and overall survival (OS) of patients with BRAFV600wild-type and BRAFV600-mutant advanced melanoma in the Netherlands.Methods:We selected patients of 18 years and over, diagnosed between 2016 and 2017 with unresectable stage IIIC or IV melanoma, registered in the Dutch Melanoma Treatment Registry. To assess the association of BRAFV600-mutation status with OS we used the Cox proportional-hazards model.Results:A total of 642 BRAFV600wild-type and 853 mutant patients were included in the analysis. Median OS did not differ significantly between both groups, 15.2 months (95% confidence interval [CI]: 13.2-19.2) versus 20.6 months (95% CI: 18.3-25.0). Survival rates at 6 and 12 months were significantly lower for BRAFV600wild-type patients compared with BRAFV600-mutant patients, 72.0% (95% CI: 68.6-75.6) and 56.0% (95% CI: 52.2-60.0) versus 83.4% (95% CI: 80.9-85.9) and 65.7% (95% CI: 62.6-69.0). Two-year survival was not significantly different between both groups, 41.1% (95% CI: 37.2-45.3) versus 47.0% (95% CI: 43.6-60.6). Between 0 and 10 months, BRAFV600wild-type patients had a decreased survival with a hazard ratio for OS of 2.00 (95% CI: 1.62-2.46) but this effect disappeared after 10 months. At 12 months, BRAFV600-mutant patients had started with second-line systemic treatment more often compared with BRAFV600wild-type patients (50% vs. 19%).Conclusion:These results suggest that advanced BRAFV600wild-type melanoma patients have worse survival than BRAFV600-mutated patients during the first 10 months after diagnosis because of less available treatment options.
Original languageEnglish
Pages (from-to)82-89
Number of pages8
JournalAmerican Journal of Clinical Oncology: Cancer Clinical Trials
Issue number2
Publication statusPublished - 1 Feb 2021


  • BRAF mutation
  • BRAF/MEK inhibitors
  • CTLA-4 inhibitor
  • National Registry
  • advanced melanoma
  • anti-PD-1-ligands
  • checkpoint inhibitors

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