Genetic characteristics and response to systemic therapies of acral lentiginous melanoma at a tertiary care center-a retrospective review.

Background: Acral lentiginous melanoma (ALM) is an aggressive subtype of cutaneous malignant melanomas that accounts for 50-80% of melanomas in ethnic minorities. Studies on the genetic profile of these tumors largely result from cohorts in Europe, Asia, and Latin America, few inclusive of Black patients.
Objective: We aim to describe the clinicopathological and genetic characteristics in a diverse cohort of ALM patients.
Methods: A retrospective analysis of 93 patients with a pathology confirmed diagnosis of ALM between March 1984 and October 2020 was conducted at a large tertiary care center. Melanoma mutation panel testing for frequently mutated regions of the BRAF, NRAS, KIT and PIK3CA genes were reviewed in patient records when available.
Results: Of the 93 patients identified, 62.4% were Caucasian, 25.8% Black, 4.30% Hispanic, 4.30% Asian, and 3.22% identified as other. Fourteen of 17 patients receiving targeted or immunologic agents experienced disease progression during treatment, including all patients with a BRAF V600E mutation.
Limitations: This was a single-center retrospective analysis.
Conclusion: Response to targeted and immunologic therapies in ALM patients was overwhelming poor, particularly in BRAF V600E-mutated tumors in contrast to the positive prognosis associated with BRAF V600E mutations in other advanced cutaneous melanoma subtypes.
Competing Interests: Declaration of Competing Interest The authors declare no conflicts of interest related to this work.
(Copyright © 2021 National Medical Association. Published by Elsevier Inc. All rights reserved.)