Identifying treatment options for BRAFV600 wild-type metastatic melanoma: A SU2C/MRA genomics-enabled clinical trial

Patricia M. LoRusso, Aleksandar Sekulic, Jeffrey A. Sosman, Winnie S. Liang, John Carpten, David W. Craig, David B. Solit, Alan H. Bryce, Jeffrey A. Kiefer, Jessica Aldrich, Sara Nasser, Rebecca Halperin, Sara A. Byron, Mary Jo Pilat, Scott A. Boerner, Diane Durecki, William P.D. Hendricks, Daniel Enriquez, Tyler Izatt, Jonathan KeatsChristophe Legendre, Svetomir N. Markovic, Amy Weise, Fatima Naveed, Jessica Schmidt, Gargi D. Basu, Shobana Sekar, Jonathan Adkins, Erica Tassone, Karthigayini Sivaprakasam, Victoria Zismann, Valerie S. Calvert, Emanuel F. Petricoin, Leslie Anne Fecher, Christopher Lao, J. Paul Eder, Nicholas J. Vogelzang, Jane Perlmutter, Mark Gorman, Barbara Manica, Lisa Fox, Nicholas Schork, Daniel Zelterman, Michelle DeVeaux, Richard W. Joseph, C. Lance Cowey, Jeffrey M. Trent*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


Although combination BRAF and MEK inhibitors are highly effective for the 40-50% of cutaneous metastatic melanomas harboring BRAFV600 mutations, targeted agents have been ineffective for BRAFV600wild-type (wt) metastatic melanomas. The SU2C Genomics- Enabled Medicine for Melanoma Trial utilized a Simon two-stage optimal design to assess whether comprehensive genomic profiling improves selection of molecular-based therapies for BRAFV600wt metastatic melanoma patients who had progressed on standard-of-care therapy, which may include immunotherapy. Of the response-evaluable patients, binimetinib was selected for 20 patients randomized to the genomics-enabled arm, and nine were treated on the alternate treatment arm. Response rates for 27 patients treated with targeted recommendations included one (4%) partial response, 18 (67%) with stable disease, and eight (30%) with progressive disease. Post-trial genomic and protein pathway activation mapping identified additional drug classes that may be considered for future studies. Our results highlight the complexity and heterogeneity of metastatic melanomas, as well as how the lack of response in this trial may be associated with limitations including monotherapy drug selection and the dearth of available single and combination molecularly-driven therapies to treat BRAFV600wt metastatic melanomas.

Original languageEnglish
Article numbere0248097
JournalPLoS ONE
Issue number4 April
StatePublished - Apr 2021
Externally publishedYes


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