Big Costs for Little Gain in Ovarian Cancer

BRAF mutations, as has been well-documented for amplified human epidermal growth factor receptor 2 (HER2)/neu in breast cancer treated with HER2-targeted therapies. 11 Others have previously reported that BRAF-mutant thyroid cancers are more likely to invade regional lymph nodes then their wildtype counterparts. 12 And there appears to be a strong association between BRAF mutation and the highly favorable micro-satellite unstable phenotype in colorectal cancer. 13 Thus, the role of any given oncogenic alteration must be considered in the context of the other concomitant changes required to promote carcinogenesis.Only in this way can one explain how the same mutated oncogene can be present in a poor prognosis group in one tumor type and in a good prognosis group in another.In fact, in melanoma it may be that the associated genetic or epigenetic changes that coexist with BRAF mutation that are the true drivers of a difference in tumor biology among these patients.As the technology to interrogate numerous oncogenes and tumor suppressor genes in parallel becomes more widely available, the next generation of investigations into genetic changes that relate to prognosis will likely describe more complex signatures or networked contributors to aggressive biology.For now, we know that BRAF mutation is a powerful predictive marker, and is in the running to become the first molecular prognostic marker in melanoma.