Boris C. Bastian, MD, PhD: BioMerieux and Other Tests in Melanoma

Which test do you prefer? Is the bioMérieux test preferred, since it detects V600E and K more exclusively?

The bioMerieux test is definitely a step forward in that it basically decreases the number of false negatives. But it’s still missing all the other variants that we discussed earlier—V600 mutations that are not E or K or mutations immediately nearby.

CASE: Metastatic Melanoma

Michelle is a 55-year old who was referred by her primary care physician to receive a biopsy for a suspicious mole during a routine visit. Results of the biopsy and other subsequent tests revealed that she had an M1b stage tumor (lung metastasis and a less than ULN LDH level). Her ECOG PS is 0.

• Initial BRAF testing using a laboratory-developed test was negative for BRAF V600E L

She was referred from the community setting to a tertiary center, at which point a second test was conducted using the bioMérieux HxID-BRAF kit. This assay was positive for the BRAF V600K mutation

• Following the finding ofBRAF-positivity, Michelle was prescribed the combination of dabrafenib (150 mg BID) and trametinib (1 mg daily)