The Impact of BRAF Mutational Status on Survival in Melanoma Patients: Single Centre Experience

Melanoma accounts for less than 2% of all cancers worldwide but is responsible for 80% of skin cancer-related deaths. Among the various genetic alterations in melanoma, BRAF and NRAS mutations are the most common. While multiple studies have confirmed the involvement of BRAF in melanoma, its role as a prognostic marker remains disputed. However, the BRAF V600E mutation is clinically significant, as its presence determines eligibility for targeted therapy with BRAF inhibitors. This retrospective study aimed to correlate BRAF mutation status with the clinicopathological characteristics of primary skin melanoma, assess the impact of BRAF-mutated versus BRAF wild-type melanoma on disease progression and overall survival, and evaluate the influence of BRAF inhibitor therapy on survival outcomes. 152 melanoma patients along with available clinical data were included in this study. BRAF mutational status was determined by allele-specific real-time PCR between 2013 and 2020 at the Clinical Hospital Centre Rijeka. Of the 152 patients, 80 (52%) had BRAF-mutated melanoma, which showed a slight predilection for the trunk. Histologically, nodular melanoma was the most commonly associated subtype. No significant difference was observed in terms of disease progression and overall survival between BRAF-mutated and BRAF wild-type patients. However, in patients with BRAF-mutated melanomas, those who received BRAF inhibitors exhibited improved survival outcomes in advanced disease stages (p = 0.0025). Our study indicates that BRAF-mutated melanoma patients with distant metastases receiving BRAF inhibitors have significantly improved survival compared to those not receiving targeted therapy, supporting the clinical benefit of BRAF inhibitor use in appropriately selected patients.