• Taylor Jamerson, Vito W Rebecca, and Crystal Aguh.
• University of Michigan Medical School, Ann Arbor, MI USA.
• J Natl Med Assoc. 2022 Feb 1; 114 (1): 7-11.

BackgroundAcral 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.ObjectiveWe aim to describe the clinicopathological and genetic characteristics in a diverse cohort of ALM patients.MethodsA 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.ResultsOf 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.LimitationsThis was a single-center retrospective analysis.ConclusionResponse 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.Copyright © 2021 National Medical Association. Published by Elsevier Inc. All rights reserved.

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