BRAF vs. wild-type melanoma: What’s the difference?

3 min read

If you or your loved one has been diagnosed with melanoma, you may have come across the terms BRAF and wild-type. What do they mean, and does this influence your prognosis and treatment strategy? Read on to find out.




BRAF is a gene that makes a protein that helps control cell growth. It’s known as an oncogene. Normally, an oncogene will regulate the growth of your cells. However, if a mutation (change) in a BRAF gene occurs, it can trigger uncontrollable cell growth, which can lead to cancer. Melanoma cancers with a BRAF mutation tend to be more serious than those without the mutation.


BRAF mutations are not inherited – they are acquired. This means that, for some reason, a mutation occurs in your body’s cells, leading to unregulated cell growth.


To see if you have a BRAF mutation, a test called a tumour biopsy will be done. The cells are tested to see if they contain the mutation. BRAF testing is generally recommended for all patients with stage III and IV melanoma. Being positive for BRAF does not mean you have melanoma – but you are at a higher risk of developing it. Your doctor may recommend more frequent skin exams to keep an eye on you.






Wild-type describes melanoma that does not have a mutation (i.e., BRAF-negative). Although BRAF-positive melanoma tends to be more aggressive than wild-type melanoma, there are other factors that impact how serious melanoma can be. This includes the depth of a tumour, the number of lymph nodes involved, and whether or not it has spread to other areas of the body.


Can immunotherapy be used in BRAF-positive and wild-type melanoma?

Yes, immunotherapy may be used for melanoma patients who are both BRAF-positive and BRAF-negative (wild-type). Immunotherapy helps to restore the immune system’s ability to fight cancer. You may have immunotherapy to help:

  • Delay or prevent the cancer from coming back (recurring) after it and its metastases have been completely removed by surgery
  • Treat cancer that has spread or cannot be removed by surgery


There are different types of immunotherapy used to treat melanoma. They include:

  • PD-1 inhibitors. These work by blocking an “immune checkpoint receptor” called PD-1, which is a protein found on immune cells (T cells) that can switch off their activity. By attaching to PD-1, the inhibitors block its action and prevent it from switching off the T cells – increasing their activity against cancer cells.
  • CTLA-4 inhibitors. These work by attaching to the protein CTLA-4, which can switch off the activity of T cells. By attaching to CTLA-4, the inhibitors block its action and prevent it from switching off the T cells – increasing their activity against cancer cells.


Certain types of immunotherapy can be used in combination. To learn more, ask your doctor about your treatment options.



Are there other treatment options for BRAF-positive vs. wild-type melanoma?

There are other types of targeted therapies that are used specifically in people with BRAF-positive melanoma. These therapies include BRAF inhibitors and MEK inhibitors. If you or your loved one has BRAF-positive melanoma, you may receive either, or both. People with wild-type melanoma do not receive BRAF or MEK inhibitors.

Radiation, chemotherapy and surgery can also be used to treat melanoma.

Be informed about your treatment options.

Talk to your doctor about what plan they recommend based on your type, and stage, of melanoma. Be sure to get answers to all the questions you have.

When caught early, melanoma is highly treatable. Check your skin regularly using the Skin Self-Check tool.