Current immunotherapy for acral melanoma and research advances
10.3867/j.issn.1000-3002.2025.03.009
- VernacularTitle:肢端黑色素瘤免疫治疗现状及研究进展
- Author:
Yujia LIU
1
;
Zhengyun ZOU
1
Author Information
1. 南京大学医学院附属鼓楼医院肿瘤中心,江苏南京 210008
- Publication Type:Journal Article
- Keywords:
acral melanoma;
immunotherapy;
combination therapy
- From:
Chinese Journal of Pharmacology and Toxicology
2025;39(3):233-240
- CountryChina
- Language:Chinese
-
Abstract:
Acral melanoma(AM)is a distinct and aggressive subtype of melanoma characterized by high metastatic potential and poor prognosis.The pathogenesis and therapeutic strategies for advanced AM differ significantly from those of other melanoma subtypes,yet AM has received relatively less attention.AM exhibits high heterogeneity and a low tumor mutation burden.Mutations in braf,nras,and the tert promoter occur at much lower frequencies in AM than in cutaneous melanoma,limiting the effectiveness of treatments such as recombinant B-Raf proto oncogene serine/threonine protein kinase(BRAF)inhibitors.Additionally,reduced tumor immunogenicity due to low tumor-infiltrating lymphocyte levels contributes to the limited efficacy of immune checkpoint inhibitors,including anti-programmed death-1 and anti-cytotoxic T-lymphocyte-associated protein 4 therapies.Recent discoveries of novel therapeutic targets,such as receptor tyrosine kinases and cyclin-dependent kinases,along with emerging immune checkpoints,including V-domain immunoglobulin suppressor of T cell activation,adenosine A2A receptor,T cell immunoglobulin and ITIM domain,and T cell immunoglobulin and mucin-domain containing-3,offer new prospects for improving AM patient outcomes.Many AM treatments remain in the experimental stage,with research focusing on small-molecule targeted therapies,immune checkpoint inhibitors,and tumor microenvironment modulation.Combination strategies incorporating next-genera-tion cell therapies,oncolytic virus therapies,and therapeutic vaccines are also gaining prominence.Notably,clinical trials of personalized mRNA cancer vaccines have been promising,while antibody-drug conjugate and radionuclide-conjugated therapies present additional opportunities for enhancing AM prognosis.This article summarizes the cellular immune characteristics,mutation profiles,and tumor microenvironment of AM,as well as the current therapeutic strategies and advancements in the hope of expanding clinical benefits for AM patients.
