Novel Clinical PET Tracers in the Pipeline for Melanoma

The aim of this review is to provide an overview of novel clinical PET tracers in the pipeline for melanoma. Secondarily, to provide a head-to-head comparison with the current clinical standard used in clinical practice, [¹⁸F]FDG, if available.

[¹⁸F]FDG PET/CT has become important in the clinical setting for melanoma as it serves many purposes, but lacks other important qualities due its nonspecific nature. There is an increased clinical need for specific tracers. Many new PET tracers, such as melanin-targeted and antibody-based probes, have been studied in melanoma with the intention of achieving high sensitivity detection of metastases and small lesions. There are four main groups of PET tracers in de pipeline for melanoma: melanin-, FAP-, PD-1/PD-L1- and CD8+ T cell-tracers. Melanin-targeted tracers and FAP inhibitors revealed potential for diagnostic application, whilst PD-1/PD-L1 and CD8+ T cell tracers demonstrated potential for response assessment and prediction. In conclusion, research has revealed promising results from current (ongoing) studies; however, more melanoma patients need to be included to further assess the value of these tracers.