Next generation sequencing for personalized therapy: About a class III BRAF N581K mutation associated to NRAS Q61L mutation in malignant melanoma: Case report

In metastatic stage, therapeutic approach for malignant melanoma is particularly based on performance status, sites, and BRAF V600 status (BRAF V600E/V600K or V600R (class I mutations). most cases, mutations NRAS are mutually exclusive to each other. However, some rare class III preferentially associated with a mutation, leading the MAP Kinase pathway activation subsequent cell proliferation. Melanomas this double mutation difficult treat because of lack codified options. We report patient melanoma, harboring (N581K) (Q61L) treatment failure. He was treated in second line, after immunotherapy, by monotherapy MEK inhibitor (MEKi), which underline interest NGS (Next Generation Sequencing) early identify all enabling onco-dermatologist discuss treatment. Rare non represent 3 14% mutants aim communication promote next generation sequencing extend paradigm individually target therapy into different spectrum patients.