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Have you been treated with vemurafenib? We want to hear your story.

Recent news indicates that the investigational melanoma treatment vemurafenib, also known as PLX 4032 and now the brand name Zelboraf, may receive approval from the U.S. Food and Drug Administration as soon as this week.

If an approval is granted, major U.S. news outlets may be interested in speaking with patients or family members of those who have used vemurafenib to treat advanced melanoma. If you are interested in potentially sharing your story, please complete the survey below.

Specifically, we are looking for people who:

- Are living with advanced melanoma

- Have participated in a clinical trial for vemurafenib (also known as PLX4032 or Zelboraf)

- Are available for media interviews (most likely by telephone, but people living in major cities may be invited to participate in a television interview if the opportunity arises)

If this describes you or someone you know, please let us know as soon as possible by completing the form below. We'll contact you if a reporter would like to set up an interview.

Thanks for your help! This is a great opportunity to bring more attention to the need for innovative treatment options for people with melanoma.

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Contact Information: Please include home and mobile numbers in the field below.

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What is your home phone number?

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What is your mobile phone number?

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Is there a time during the day when you prefer NOT to be contacted?

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How old are you?

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When were you diagnosed with advanced melanoma (month and year)?

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Have you participated in a clinical trial for vemurafenib? When and where was the trial conducted?

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Please briefly describe your experience with the clinical trial, and what the outcome was for you. Why do you feel compelled to tell this story?

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How would the approval of vemurafenib impact your treatment plan for melanoma?

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Is there anything else you would like to share about your experience with vemurafenib?

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