Treatment implications of the emerging molecular classification system for melanoma Journal Article


Authors: Romano, E.; Schwartz, G. K.; Chapman, P. B.; Wolchock, J. D.; Carvajal, R. D.
Article Title: Treatment implications of the emerging molecular classification system for melanoma
Abstract: Melanoma is an aggressive disease with few standard treatment options. The conventional classification system for this disease is based on histological growth patterns, with division into four subtypes: superficial spreading, lentigo maligna, nodular, and acral lentiginous. Major limitations of this classification system are absence of prognostic importance and little correlation with treatment outcomes. Recent preclinical and clinical findings support the notion that melanoma is not one malignant disorder but rather a family of distinct molecular diseases. Incorporation of genetic signatures into the conventional histopathological classification of melanoma has great implications for development of new and effective treatments. Genes of the mitogen-associated protein kinase (MAPK) pathway harbour alterations sometimes identified in people with melanoma. The mutation Val600Glu in the BRAF oncogene (designated BRAFV600E) has been associated with sensitivity in vitro and in vivo to agents that inhibit BRAFV600E or MEK (a kinase in the MAPK pathway). Melanomas arising from mucosal, acral, chronically sun-damaged surfaces sometimes have oncogenic mutations in KIT, against which several inhibitors have shown clinical efficacy. Some uveal melanomas have activating mutations in GNAQ and GNA11, rendering them potentially susceptible to MEK inhibition. These findings suggest that prospective genotyping of patients with melanoma should be used increasingly as we work to develop new and effective treatments for this disease. © 2011 Elsevier Ltd.
Journal Title: Lancet Oncology
Volume: 12
Issue: 9
ISSN: 1470-2045
Publisher: Elsevier Science, Inc.  
Date Published: 2011-09-01
Start Page: 913
End Page: 922
Language: English
DOI: 10.1016/s1470-2045(10)70274-6
PROVIDER: scopus
PUBMED: 21349766
DOI/URL:
Notes: --- - "Export Date: 3 October 2011" - "CODEN: LOANB" - "Source: Scopus"
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  1. Gary Schwartz
    385 Schwartz
  2. Richard D Carvajal
    148 Carvajal
  3. Paul Chapman
    326 Chapman
  4. Emanuela Romano
    11 Romano