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Living with cancer· Appointment prep

Appointment sheet: BRAF V600-mutant melanoma

One page to bring and write on: your details, the questions for BRAF V600-mutant melanoma plus your own, the words you may hear, what to bring, the treatments the standard of care names, and room for the answers and agreed next steps. What you type stays in this browser. Print it or save it as a PDF. New to all this? Start with the first 60 days. Orientation, not medical advice.

Tick the questions to print

All of this cancer's questions start ticked. Untick what does not apply; ticks are kept in this browser. .

Your own questions

Shared with the prep pack, so questions you add there appear here too.

Print or save as PDF

Use (or Ctrl+P, Cmd+P on a Mac). To keep a copy, choose Save as PDF as the destination in the print dialog. Only the sheet prints; the controls stay on screen. Your typed notes print where you typed them; empty fields print as ruled lines to write on.

Appointment sheet

BRAF V600-mutant melanoma

Prepared with OnCo (onco.cc/prep/braf-v600-melanoma/). Orientation, not medical advice; your team knows your case.

My details

Name
Date of appointment
Hospital and clinician
Who is coming with me

What I know, what is unclear, changes to discuss

Saved in this browser
What I know so far
What is unclear to me
Changes since last time

My questions

23 on the sheet
Newly diagnosed
  1. 1.What is my exact diagnosis, stage, and grade, and which tests established them?
  2. 2.Which biomarkers have been tested on my tumour (for example BRAF V600 mutation by sequencing or immunohistochemistry, Lactate dehydrogenase, Number of metastatic sites, NRAS, MEK1 and BRAF splice variants at resistance, Circulating tumour DNA BRAF V600 for response monitoring), and what were the results?
  3. 3.Which subtype is my cancer, and does that change the recommended treatment?
  4. 4.Is germline (inherited) genetic testing recommended for me or my family?
Advanced, first line
  1. 5.For my situation (advanced, first line), which of the standard options do you recommend and why?
  2. 6.Am I a candidate for Relatlimab + nivolumab, Dabrafenib + trametinib, Encorafenib or related drugs, and what side effects should I expect?
  3. 7.How do the results of DREAMseq (ECOG-ACRIN EA6134) and CheckMate 067 apply to someone like me?
Advanced, after immunotherapy
  1. 8.For my situation (advanced, after immunotherapy), which of the standard options do you recommend and why?
  2. 9.Am I a candidate for Dabrafenib, Trametinib, Encorafenib or related drugs, and what side effects should I expect?
  3. 10.How do the results of COMBI-d and coBRIM apply to someone like me?
Resected stage III
  1. 11.For my situation (resected stage iii), which of the standard options do you recommend and why?
  2. 12.Am I a candidate for Dabrafenib + trametinib, Nivolumab, Pembrolizumab, and what side effects should I expect?
  3. 13.How do the results of COMBI-AD and NADINA apply to someone like me?
Brain metastases
  1. 14.For my situation (brain metastases), which of the standard options do you recommend and why?
  2. 15.Am I a candidate for Dabrafenib + trametinib, and what side effects should I expect?
  3. 16.How do the results of CheckMate 204 apply to someone like me?
Triplet therapy
  1. 17.For my situation (triplet therapy), which of the standard options do you recommend and why?
  2. 18.Am I a candidate for Atezolizumab, Vemurafenib, Cobimetinib, and what side effects should I expect?
Any stage
  1. 19.Are there clinical trials I could join, for example of A Study to Assess Naporafenib (ERAS-254) Administered With Trametinib in Patients With NRAS-mutant Melanoma (SEACRAFT-2), Naporafenib, Belvarafenib in Combination With Cobimetinib in Patients With Locally Advanced or Metastatic NRAS-Mutant Melanoma, Study of Efficacy and Safety of LXH254 Combinations in Patients With Previously Treated Unresectable or Metastatic Melanoma?
  2. 20.Would a second opinion at a high-volume centre change anything, and can you help arrange it?
  3. 21.What supportive care (symptom control, nutrition, exercise, mental health, financial help) is available from the start?
  4. 22.I read that “Responses to targeted therapy are almost universal but most are not durable, and resistance through MAPK reactivation has no approved answer”. How does that affect my plan?
  5. 23.I read that “Whether a short targeted-therapy induction before immunotherapy helps has not been settled in a phase 3 trial”. How does that affect my plan?

The words I may hear

  • BRAF V600E mutation: A single spelling change in the BRAF gene that jams a growth switch permanently on.

Tests and results to bring

Biomarker results to ask for: BRAF V600 mutation by sequencing or immunohistochemistry (required for targeted therapy), Lactate dehydrogenase (prognostic for targeted therapy benefit), Number of metastatic sites (fewer than three predicts long-term benefit), NRAS, MEK1 and BRAF splice variants at resistance, Circulating tumour DNA BRAF V600 for response monitoring (trials).

Scans and tests linked to this cancer: MRD / molecular residual disease testing.

Bring copies of scan reports, pathology and blood results, and a list of every medicine and supplement.

The treatments I may be offered

From the standard of care recorded for this cancer; which apply depends on your stage and biomarkers. Ask which the team recommends and why.

Answers and next steps

Saved in this browser
What I was told
Agreed next steps, dates and who to call