Recurred. How does this change my treatment choices, and are new targeted therapies using biomarkers (BRAF, NRAS)...

I'm sorry to hear your Melanoma has recurred. This can be a difficult situation, but there are treatment options available that may be helpful.

According to the NCCN Clinical Practice Guidelines in Oncology for Melanoma, when Melanoma recurs, the treatment approach depends on factors like the location and extent of the recurrence, as well as your overall health and previous treatments.

For recurrent Melanoma, the NCCN guidelines recommend considering targeted therapies if the tumor tests positive for certain genetic mutations, such as BRAF or NRAS. Specifically:

• BRAF-targeted therapies like vemurafenib, dabrafenib, and encorafenib may be options if the tumor has a BRAF mutation. These are FDA-approved for unresectable or metastatic Melanoma with a BRAF mutation.

• For NRAS-mutant Melanoma, MEK inhibitors like binimetinib may be considered based on recent clinical trial data.

The American Cancer Society also notes that immunotherapy drugs like pembrolizumab and nivolumab may be used for recurrent Melanoma, regardless of biomarker status.

It's important to discuss all of your treatment options with your oncology team, as the best approach will depend on the specifics of your case. They can help you understand the potential benefits and risks of different therapies. I recommend speaking with your doctor to determine the most appropriate next steps for managing your recurrent Melanoma.

Sources:

• NCCN Clinical Practice Guidelines in Oncology for Melanoma, Version 2.2022
• American Cancer Society, "Melanoma Skin Cancer Treatment"
• FDA approvals for BRAF-targeted and immunotherapy drugs in Melanoma