“Acral melanoma was found to have higher recurrence and lower survival rates than other types of melanoma and may require more aggressive surgical intervention, according to researchers.
“The researchers selected patients from a prospectively enrolled cohort of primary melanoma patients at NYU Langone Medical Center; 61 patients with acral melanoma and 183 patients with non-acral melanoma were included. Median follow-up was 33 months in the acral melanoma cohort and 58 months in the non-acral melanoma cohort.”
“A rare type of melanoma that disproportionately attacks the palms and soles and under the nails of Asians, African-Americans, and Hispanics, who all generally have darker skins, and is not caused by sun exposure, is almost twice as likely to recur than other similar types of skin cancer, according to results of a study in 244 patients.
“The finding about acral lentiginous melanoma, as the potentially deadly cancer is known, is part of a study to be presented May 31 by researchers at the Perlmutter Cancer Center of NYU Langone at the annual meeting of the American Society of Clinical Oncology in Chicago.”
Carvajal RD. Journal of Clinical Oncology. Aug 10, 2013.
“Hodi et al reported the ﬁnal results of a multicenter phase II trial of imatinib in patients with advanced melanoma harboring mutations or ampliﬁcation of the KIT proto-oncogene. KIT is a transmembrane receptor tyrosine kinase, normally expressed on melanocytes, that plays a critical role in melanocyte migration, survival, proliferation, and differentiation. Mutations and ampliﬁcation of KIT have been identiﬁed in melanomas arising from mucosal, acral or chronically sun-damaged surfaces, and they characterize a distinct genetic subset of disease. The alterations identiﬁed are, in most instances, mutually exclusive of BRAF and NRAS mutations and lead to constitutive activation of downstream signaling pathways including the MAPK, PI3K/AKT, and JAK/STAT pathways.”
Hodi FS, Corless CL, Giobbie-Hurder A, Fletcher JA, et al. J Clin Oncol. Jun 17, 2013.
“Amplifications and mutations in the KIT proto-oncogene in subsets of melanomas provide therapeutic opportunities…We conducted a multicenter phase II trial of imatinib in metastatic mucosal, acral, or chronically sun-damaged (CSD) melanoma with KIT amplifications and/or mutations…Melanomas that arise on mucosal, acral, or CSD skin should be assessed for KIT mutations. Imatinib can be effective when tumors harbor KIT mutations, but not if KIT is amplified only. NRAS mutations and KIT copy number gain may be mechanisms of therapeutic resistance to imatinib.“