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Prognostic and predictive biomarkers in melanoma.
Nigel G Maher1, Ismael A Vergara2, Georgina V Long3
1Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia; Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital and NSW Health Pathology, Sydney, NSW, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
Pathology
|January 20, 2024
Summary
Biomarkers are crucial for melanoma patient care, predicting outcomes and guiding treatment for both primary and metastatic disease. Further research is needed to integrate emerging biomarkers into routine clinical practice.
Area of Science:
- Oncology and Pathology
- Dermatology
- Clinical Decision-Making
Background:
- Biomarkers are essential for managing melanoma patients, aiding in prognosis prediction for primary tumors and guiding treatment selection for advanced stages.
- Systemic therapies like immune checkpoint inhibitors (ICI) and BRAF-targeted drugs have improved outcomes but response variability necessitates refined patient stratification.
Approach:
- This review examines established and emerging prognostic and predictive pathological biomarkers relevant to primary and metastatic melanoma.
- Focus is placed on biomarkers that inform clinical decisions, including risk prediction tools, sentinel lymph node biopsy selection, and tailored follow-up protocols.
Key Points:
- Gene expression profiles and nomograms are emerging tools for prognostication and sentinel lymph node risk assessment in primary melanoma.
- Established biomarkers include BRAF V600 mutations for targeted therapy in metastatic melanoma and HLA-A*02:01 for uveal melanoma treatment.
- Several predictive biomarkers for ICI therapies require further validation and clinical utility assessment before integration into guidelines.
Conclusions:
- Biomarkers significantly refine clinical decision-making across the melanoma spectrum, from early-stage prognostication to advanced disease treatment selection.
- Continued research and validation are critical for the seamless integration of novel prognostic and predictive biomarkers into routine melanoma care.
