Journal Article Review Epublish
PubMed: 40361349 DOI: 10.3390/cancers17091422
Clinical Applications of the Molecular Landscape of Melanoma: Integration of Research into Diagnostic and Therapeutic Strategies.
Cancers (Basel) 17(9)
Authors: Imre Lőrinc Szabó, Gabriella Emri, Andrea Ladányi, József Tímár
Affiliations
- Department of Dermatology, MTA Centre of Excellence, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary.
- HUN-REN-UD Allergology Research Group, University of Debrecen, 4032 Debrecen, Hungary.
- Department of Surgical and Molecular Pathology, National Institute of Oncology, 1122 Budapest, Hungary.
- National Tumor Biology Laboratory, National Institute of Oncology, 1122 Budapest, Hungary.
- Department of Pathology, Forensic and Insurance Medicine, Semmelweis University, 1091 Budapest, Hungary.
Abstract
The molecular landscape of cutaneous melanoma is complex and heterogeneous, and a deeper understanding of the genesis and progression of the tumor driven by genetic alterations is essential for the development of effective diagnostic and therapeutic strategies. Molecular diagnostics and the use of biomarkers are increasingly playing a role in treatment decisions. However, further research is urgently needed to elucidate the relationships between complex genetic alterations and the effectiveness of target therapies (although BRAF mutation is still the only targeted genetic alteration). Further research is required to exploit other targetable genetic alterations such as NRAS, KIT or rare mutations. Treatment guidelines for cutaneous melanoma are continually evolving based on data from recent and ongoing clinical trials. These advancements reflect changes mainly in the optimal timing of systemic therapy and the choice of combination therapies increasingly tailored to molecular profiles of individual tumors. Mono- or combination immunotherapies demonstrated unprecedented success of melanoma treatment; still, there is room for improvement: though several factors of primary or acquired resistance are known, they are not part of patient management as biomarkers. The novel developments of cancer vaccines to treat melanoma (melanoma-marker-based or personalized neoantigen-based) are encouraging; introduction of them into clinical practice without proper biomarkers would be the same mistake made in the case of first-generation immunotherapies.
MeSH
Melanoma, Neoplasms, Biomarkers, Immunotherapy, Research, Therapeutics, Mutation