This retrospective look at 94 consecutive patients with melanoma brain mets resected at UCSF aimed to characterize which intracranial features predict worse outcomes. Those with BRAF alteration (n=38) had remarkably worse median intracranial progression-free survival (3.6 v 11 months) and overall survival (10 v 23 months). Further analysis demonstrated BRAF mutated brain tumors had decreased tumor mutational burden and decreased immune cell presence. In the same vein, patients with BRAF-mutated tumors appeared to achieve no survival benefit when receiving immune checkpoint inhibition while those with BRAF wildtype tumors saw a significant survival benefit. | Vasudevan, JAMA Netw Open 2023
