{"entity":{"id":"braf-fusion","kind":"biomarker","name":"BRAF fusion or rearrangement","aka":["BRAF fusion","KIAA1549-BRAF","KIAA1549::BRAF","BRAF rearrangement","BRAF-fused glioma"],"tldr":"A BRAF fusion joins another gene to the BRAF kinase, most often KIAA1549 in paediatric low-grade glioma. Tovorafenib is approved for children whose relapsed low-grade glioma carries a BRAF fusion or V600 mutation.","summary":"KIAA1549::BRAF is the hallmark of pilocytic astrocytoma and most paediatric low-grade gliomas; other partners and rare BRAF fusions occur in melanoma, thyroid and pancreatic acinar cancers. Fusions behave as class II alterations and respond poorly to first-generation BRAF inhibitors, which can paradoxically activate them. Tovorafenib (Ojemda, 2024) is labelled for patients 6 months and older with relapsed or refractory paediatric low-grade glioma harbouring a BRAF fusion or rearrangement or a BRAF V600 mutation; FoundationOne CDx is the listed companion diagnostic (P170019/S054). Detection needs RNA or DNA sequencing that captures rearrangements, or FISH; hotspot PCR misses them.","asOf":"2026-09-23","links":[{"label":"OJEMDA prescribing information (DailyMed)","url":"https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ea3a9631-3a66-6a7c-e053-2995a90ae2ad"}],"tags":["biomarker","braf"],"related":["braf-v600e","braf-class-ii-iii"],"cancers":["paediatric-low-grade-glioma","melanoma"],"sections":[],"technologies":[],"targets":[],"drugs":["tovorafenib","foundationone-cdx"],"companies":[],"institutions":[],"pathways":[],"terms":["gene-fusion","braf-v600-mutation"],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"target":"braf","measurement":"sequencing-variant","scoringRule":{"text":"A BRAF gene fusion or rearrangement (for example KIAA1549::BRAF) detected by RNA or DNA sequencing or FISH; hotspot PCR does not detect it.","quote":"BRAF V600 mutations and BRAF fusions","source":"https://www.fda.gov/medical-devices/in-vitro-diagnostics/list-cleared-or-approved-companion-diagnostic-devices-in-vitro-and-imaging-tools","sourceLabel":"FDA: List of FDA-Authorized Companion Diagnostic Devices"},"thresholds":[{"value":"BRAF fusion or rearrangement, or BRAF V600 mutation","drugId":"tovorafenib","cancerId":"paediatric-low-grade-glioma","regulator":"FDA","source":"https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ea3a9631-3a66-6a7c-e053-2995a90ae2ad","quote":"OJEMDA is indicated for the treatment of patients 6 months of age and older with relapsed or refractory pediatric low-grade glioma (LGG) harboring a BRAF fusion or rearrangement, or BRAF V600 mutation.","status":"current"}],"tests":["foundationone-cdx","tempus-xt","trusight-oncology-comprehensive","caris-mi-profile"],"assays":["foundationone-cdx-panel"],"companionDiagnostics":[{"device":"FoundationOne CDx","maker":"Foundation Medicine","companyId":"foundation-medicine","drugs":["tovorafenib"],"indication":"Low-Grade Glioma - Tissue","pma":"P170019/S054 (01/16/2025)","source":"https://www.fda.gov/medical-devices/in-vitro-diagnostics/list-cleared-or-approved-companion-diagnostic-devices-in-vitro-and-imaging-tools"}],"forPatient":"In a child's low-grade glioma a BRAF fusion is common and, if the tumour comes back after treatment, makes tovorafenib an on-label option taken by mouth. The first-generation BRAF tablets used for V600E melanoma are not suitable for fusions. Ask whether the test used could see rearrangements, because some panels cannot."},"route":"/biomarkers/braf-fusion/","neighbours":{"biomarker":[{"id":"braf-class-ii-iii","kind":"biomarker","name":"BRAF class II and class III mutations (non-V600)","route":"/biomarkers/braf-class-ii-iii/"},{"id":"braf-v600e","kind":"biomarker","name":"BRAF V600E (and V600K)","route":"/biomarkers/braf-v600e/"}],"cancer":[{"id":"melanoma","kind":"cancer","name":"Melanoma","route":"/cancers/melanoma/"},{"id":"paediatric-low-grade-glioma","kind":"cancer","name":"Paediatric low-grade glioma","route":"/cancers/paediatric-low-grade-glioma/"}],"drug":[{"id":"foundationone-cdx","kind":"drug","name":"FoundationOne CDx / Liquid CDx","route":"/drugs/foundationone-cdx/"},{"id":"tovorafenib","kind":"drug","name":"Tovorafenib","route":"/drugs/tovorafenib/"}],"term":[{"id":"braf-v600-mutation","kind":"term","name":"BRAF V600E mutation","route":"/terms/braf-v600-mutation/"},{"id":"gene-fusion","kind":"term","name":"Gene fusion","route":"/terms/gene-fusion/"}],"target":[{"id":"braf","kind":"target","name":"BRAF","route":"/targets/braf/"}]}}