Optimal strategy in managing advanced melanoma.

Area of Science:

• Oncology
• Dermatology
• Cancer Research

Background:

• Advanced melanoma prognosis significantly improved with immune checkpoint inhibitors and BRAF/MEK inhibitor combinations.
• Acral and mucosal melanoma, prevalent in East Asia, exhibit low BRAF mutation rates, limiting targeted therapy options.
• Immune checkpoint inhibitors show reduced efficacy in acral and mucosal melanoma compared to cutaneous melanoma, linked to lower tumor mutation burden.

Purpose of the Study:

• To review the current treatment landscape for advanced melanoma.
• To compare treatment strategies and outcomes across cutaneous, acral, and mucosal melanoma subtypes.
• To explore future therapeutic prospects for advanced melanoma, particularly rare subtypes.

Main Methods:

• Literature review of studies on advanced melanoma treatment.
• Comparative analysis of treatment efficacy based on melanoma subtype.
• Synthesis of current data on immune checkpoint inhibitors and targeted therapies.
• Evaluation of tumor mutation burden and its impact on treatment response.

Main Results:

• BRAF/MEK inhibitor efficacy is limited in acral and mucosal melanoma due to low mutation frequency.
• Immune checkpoint inhibitors are the primary treatment for advanced acral/mucosal melanoma but have lower response rates.
• Cutaneous melanoma shows better response to combination therapies compared to acral and mucosal subtypes.

Conclusions:

• There is a critical need for novel therapeutic strategies for advanced acral and mucosal melanoma.
• Understanding subtype-specific molecular characteristics is crucial for developing effective treatments.
• Future research should focus on overcoming resistance mechanisms and improving immunotherapy efficacy in rare melanoma subtypes.