Biomarkers
Melanoma is biomarker-driven and immunotherapy-responsive. BRAF testing is standard for stage III-IV disease. PD-L1 is tested in some cases but not always required. Most advanced melanoma patients are candidates for immunotherapy regardless of PD-L1 status.
These are typically tested on every new diagnosis, or required before systemic therapy decisions, under current U.S. clinical guidelines.
What it is: BRAF V600E or V600K mutations. Found in ~40-50% of cutaneous melanomas.
Why test: Opens eligibility for BRAF + MEK inhibitor combinations, and some newer triplet regimens.
What it is: Serum lactate dehydrogenase — a standard lab.
Why test: Elevated LDH is part of melanoma staging (M1c vs M1b) and has prognostic value.
Tested depending on cancer stage, subtype, family history, or as part of broader NGS (next-generation sequencing) panels.
What it is: NRAS Q61 mutations, found in ~20% of melanomas.
Why test: No directly approved targeted therapy yet; informs trial eligibility and may influence immunotherapy decisions.
What it is: KIT mutations, rare in cutaneous melanoma but more common in acral, mucosal, and chronic sun-damaged subtypes.
Why test: Opens eligibility for KIT inhibitor therapy.
What it is: PD-L1 expression on tumor or immune cells.
Why test: May influence choice between anti-PD-1 monotherapy and combination ipilimumab + nivolumab. Not always required for immunotherapy eligibility.
See which FDA-approved drugs match each biomarker profile above.
Melanoma clinical trials →Active recruiting trials, many biomarker-matched.
Biomarkers explained: full guide →Deeper background on how biomarker testing works.
Germline genetic testing →Different from tumor testing; addresses inherited cancer risk and family implications.
Genetic testing cost →What germline and tumor molecular tests cost, and how insurance covers each.
BRCA test cost →What patients pay in practice for BRCA1/2 testing and ACA preventive coverage rules.