Codon-Specific BRAF V600 Mutation Spectrum and Site-Based Correlates in a North Indian Cohort of Cutaneous Melanoma

Background: Codon-specific BRAF mutations are relevant for targeted treatment in melanoma, but Indian data remain limited, and most published studies report only mutant or wild-type status. Aims and Objectives: To evaluate the spectrum of BRAF V600 variants and their clinicopathological associations in cutaneous melanoma from North India. Materials and Methods: Thirty-five primary cutaneous melanomas diagnosed between 2023 and 2025 underwent allele-specific real-time polymerase chain reaction for BRAF exon 15 codon 600 variants. Mutation status was correlated with tumour site and histopathological parameters. Results: BRAF V600 mutations were detected in 19/35 cases (54.3%). V600E was the commonest subtype (31.4%), followed by V600K (8.6%). Rare non-V600E variants (V600R, V600M, V600G, and V600D) accounted for 42.1% of mutated tumours. Mutations were more frequent in non-acral than acral melanomas (65.2% vs 33.3%, P = 0.048). BRAF -mutated tumours also showed non-significant trends towards greater Breslow thickness, higher ulceration rates, and increased mitotic activity. Targetable V600E/V600K alterations were present in 40.0% of cases. Conclusion: Codon-specific testing showed considerable BRAF heterogeneity in this cohort, with a sizeable proportion of non-V600E variants. Broader mutation testing may help identify patients suitable for targeted therapy in routine practice settings.