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Precision medicine for cancer seeks to match treatment to the genetic changes found in a patient's tumor. A new Yale study suggests that for melanoma there may be an important clue to consider: the patient's age.

In the study published Nov. 6 in Science Advances, researchers found that one melanoma mutation in a gene called BRAF showed greater growth and persistence in tumors from younger patients but declined at older ages. Mutations in another cancer-associated gene, NRAS, showed the opposite trend, becoming more prominent with age.

These differences matter because precision medicine depends on identifying which alterations cancer relies on to grow out of control. The new findings suggest that a mutation's significance may depend not only on what the change is, but also on the age at which the cancer develops.

"For a young person, when they get a BRAF mutation, that is extremely likely to lead to melanoma. But for an older person, it's less likely, though still possible," says Yale Cancer Center's Jeffrey Townsend, Ph.D., senior author of the study. "This is important because there are therapies that target BRAF. It suggests they could be less effective in older patients than in younger ones."

The research offers strong evidence that age could play a key role in interpreting tumor genetics, developing targeted therapies and designing more informative clinical trials.

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