Clinical Scorecard: Identification of Aggressive Acral Melanoma Phenotype with Depleted NK Cells and Resistance to Checkpoint Inhibition through Locus-Specific HERV Expression

At a Glance

Key Highlights

• Acral melanoma exhibits a distinct molecular profile and poor responses to immune checkpoint inhibitors.
• A three-locus HERV signature stratifies AM tumors by overall survival.
• High-risk tumors show depletion of NK cells and elevated LIN28A and HMGA2.
• Reduced odds of response to immune checkpoint inhibitors in high-risk tumors.
• Potential for HERV-K antigens as immunotherapeutic targets.

Guideline-Based Recommendations

Diagnosis

• Utilize RNA sequencing to assess locus-specific TE expression in acral melanoma.

Management

• Consider the HERV signature for prognostic evaluation and treatment planning.

Monitoring & Follow-up

• Monitor NK cell levels and HERV expression as potential indicators of tumor aggressiveness.

Risks

• High-risk tumors are associated with poor response to immune checkpoint inhibitors.

Patient & Prescribing Data

Patients diagnosed with acral melanoma.

Immune checkpoint inhibitors may have limited efficacy in high-risk acral melanoma.

Clinical Best Practices

• Integrate molecular profiling with clinical outcomes for personalized treatment strategies.
• Evaluate the immunosuppressive tumor microenvironment in acral melanoma patients.

Related Resources & Content

• Study on HERV expression in uveal melanoma