The incidence of melanoma, among the most lethal cancers, is widespread and increasing. Metastatic melanoma has a poor prognosis, representing about 90% of skin cancer mortality. The increased knowledge of tumor biology and the greater understanding of the immune system role in the anti-tumor response has allowed us to develop a more rational approach to systemic therapies. The discovery of activating BRAF mutations in half of all melanomas has led to the development of molecularly targeted therapy with BRAF and MEK inhibitors, which dramatically improved outcomes of patients with stage IV BRAF-mutant melanoma. More recently, the results of clinical phase III studies conducted in the adjuvant setting led to the combined administration of BRAF and MEK inhibitors also in patients with resected high-risk melanoma (stage III). Therefore, BRAF mutation testing has become a priority to determine the oncologist's choice and course of therapy. In this review, we will report the molecular biology-based strategies used for BRAF mutation detection with the main advantages and disadvantages of the most commonly used diagnostic strategies. The timing of such molecular assessment in patients with cutaneous melanoma will be discussed, and we will also examine considerations and approaches for accurate and effective BRAF testing.

在最致命的癌症中，黑色素瘤的发病率是普遍的并且正在增加。转移性黑色素瘤的预后较差，约占皮肤癌死亡率的90％。越来越多的肿瘤生物学知识和对免疫系统在抗肿瘤反应中的作用的深入了解，使我们能够开发出更合理的全身疗法。激活的发现布拉夫所有黑色素瘤中有一半的突变已导致使用BRAF和MEK抑制剂的分子靶向疗法的发展，这极大地改善了IV期BRAF突变型黑色素瘤患者的预后。最近，在佐剂环境中进行的临床III期研究的结果导致，在切除的高危黑色素瘤患者中也同时使用了BRAF和MEK抑制剂（III期）。因此，布拉夫突变测试已成为确定肿瘤科医生的选择和治疗过程的优先事项。在这篇评论中，我们将报告基于分子生物学的策略布拉夫突变检测具有最常用诊断策略的主要优点和缺点。将讨论在皮肤黑素瘤患者中进行此类分子评估的时机，我们还将研究考虑准确有效的考虑因素和方法布拉夫 测试。