Radiation Use During Vemurafenib Treatment

Inclusion Criteria:

* Age \> 18 years old
* Diagnosis of BRAFV600 mutated Stage IV or unresectable Stage III melanoma
* Actively receiving treatment with vemurafenib as single agent and tolerating at least 720 mg bid for one cycle (28 days).
* In the opinion of the investigator, patients who are progressing in an area where radiation may provide benefit from either:

  * Symptom control
  * Oligo-progression, defined as progression in up to 3 areas where focal treatment would provide benefit.
* Patients with brain metastases will be allowed provided they meet all of the following criteria:

  * Small, \< 1cm metastases which are untreated are allowed so long as in the opinion of the investigator they do not require immediate treatment by radiation or surgery
  * Asymptomatic, treated brain metastases which are stable for 4 weeks prior to study entry are allowed
  * If patients are requiring steroids for their brain metastases, they must be on a stable dose for two weeks prior to study entry, and maintain that steroid dosing during the radiation treatments
* Adequate bone marrow function as defined by: ANC \> 1.0 k/uL, Platelets \> 75 k/uL, Hemoglobin \> 8 g/dL
* Adequate hepatic function: Total bilirubin \< 1.5 times the institutional upper limit of normal, ALT/AST \< 2.5 times the institutional upper limit of normal
* Adequate renal function as defined by serum creatinin \< 1.5 times the upper limit of normal.
* Negative serum pregnancy test at screening for women of child bearing potential within 10 days of starting vemurafenib treatment . Women of non-childbearing potential may be included if they are either surgically sterile or have been postmenopausal for \> 1 year
* Fertile men and women must agree to use an acceptable method of birth control during treatment and for at least 2 months after discontinuation of vemurafenib.
* Able and willing to provide informed consent to an approved consent form that conforms to federal and institutional guidelines.

Exclusion Criteria:

* Screening QTc interval \> 450 msec on EKG
* Known HIV positivity or AIDS-related illness, or active HBV, or active HCV.
* Any of the following within the 6 months prior to study drug administration: myocardial infarction, severe/unstable angina, coronary/peripheral artery bypass graft, symptomatic congestive heart failure, serious cardiac arrhythmia requiring medication, uncontrolled hypertension, cerebrovascular accident or transient ischemic attack, or symptomatic pulmonary embolism.
* Malabsorption disorder that would preclude adequate vemurafenib absorption.
* Other medical condition present that in the opinion of the investigator will hinder the subjects ability to complete the study.