Loading...
A national cohort study of melanoma BRAF status, testing patterns, patient and tumour characteristics, treatment and survival in England 2016-21
Mistry, K. Jeffrey, P. Levell, N. J. Kennedy, O. Richardson, K. Craig, P. Bright, C. Taylor, S. Ragan, J. Karponis, D.
Mistry, K.
Jeffrey, P.
Levell, N. J.
Kennedy, O.
Richardson, K.
Craig, P.
Bright, C.
Taylor, S.
Ragan, J.
Karponis, D.
Abstract
BACKGROUND: Inadequacy of testing for melanoma BRAF status results in delayed access to systemic therapy. BRAF mutations and their association with patient/tumour characteristics and survival is poorly understood. OBJECTIVES: To report national data from England on the (1) frequency of molecular BRAF testing, (2) association of patient/tumour characteristics with BRAF mutations and (3) treatment received and survival of patients with BRAF mutations. METHODS: This national retrospective cohort study identified all new melanomas and molecular BRAF testing in England diagnosed from 2016 to 2021 using population-based data from the National Disease Registration Service. Multivariate logistic regression determined the association between a) BRAF testing with patient/tumour characteristics, b) BRAF genotype with patient/tumour characteristics. Age-standardised net survival (NS) analysed melanoma-specific mortality by BRAF genotype. RESULTS: Of new melanomas diagnosed, 14.4% (13138/91415) had a BRAF test registered. The proportion of successfully tested tumours that were BRAF mutated was 34.0% (4424/13012). The West Midlands tested the highest proportion of cutaneous tumours (22.6% (1783/7901)) compared to the lowest in Yorkshire and the Humber (11.0% (856/7760)). Females (OR 0.82, 95%CI 0.79-0.86) and patients >80 years old (OR 0.88, 95%CI 0.83-0.93) were less likely to be tested for BRAF. BRAF mutations were associated with being female (OR 1.16, 95%CI 1.07-1.26). Patients >80 years (OR 0.36, 95%CI 0.32-0.40) had lower odds of being BRAF mutated. Patients with BRAF mutations had a lower five-year NS (BRAF-mutated 5-year NS 55.9%, 95%CI 52.7-59.2 vs BRAF WT 5-year NS 66.5%, 95%CI 62.1-60.1), particularly in stage II disease. CONCLUSIONS: This study presents the largest dataset on national melanoma BRAF status published to date. The data highlight geographic and demographic variations in BRAF testing and the impact of BRAF mutations on survival rates, particularly stage II patients. This highlights the critical role of consistent, early and accurate testing to ensure equal care, guide treatment decisions and understand prognosis.
Description
Date
2025
Publisher
Collections
Files
Loading...
Found in UnPaywall
Adobe PDF, 1.53 MB
Keywords
Type
Article
Citation
Mistry K, Jeffrey P, Levell NJ, Kennedy O, Richardson K, Craig P, et al. A national cohort study of melanoma BRAF status, testing patterns, patient and tumour characteristics, treatment and survival in England 2016-21. The British journal of dermatology. 2025 Sep 3. PubMed PMID: 40902091. Epub 2025/09/03. eng.