Molecular Classification of Melanoma

Rodrigo Arrangoiz MS, MD, FACS, FSSO
  • The molecular classification of melanoma, considering the increasing incidence rates projected for 2025 in the United States and the associated risk factors such as ultraviolet (UV) exposure, demographic changes, and genetic predispositions:
    • Is primarily based on the genetic alterations and the degree of cumulative sun damage (CSD)
  • Low-CSD Melanomas:
    • These include superficial spreading melanomas and nodular melanomas:
      • Which are often characterized by BRAF mutations, particularly the BRAFV600E variant
    • These melanomas are typically associated with:
      • Intermittent, intense UV exposure
  • High-CSD Melanomas:
    • These include lentigo maligna melanomas and desmoplastic melanomas
    • They often have a high mutation burden and can harbor:
      • NRAS mutations, TP53 mutations, and other non-V600E BRAF mutations
    • These melanomas are associated with chronic, cumulative UV exposure
  • Non-CSD Melanomas:
    • These include acral lentiginous melanomas and mucosal melanomas:
      • Which usually do not show BRAF, NRAS, or NF1 mutations (triple wild-type)
      • However, they may have mutations in C-KIT, GNAQ, or GNA11 genes
    • These melanomas are not related to UV exposure
  • Familial Melanomas:
    • These are often associated with germline mutations in genes such as:
      • CDKN2A and MC1R:
        • Which significantly increase melanoma risk
        • These genetic changes are inherited and present in all body cells
  • The molecular classification of melanoma is crucial for guiding targeted therapies and improving patient outcomes:
    • For instance, BRAF inhibitors (e.g., vemurafenib, dabrafenib) and MEK inhibitors (e.g., trametinib):
      • Are effective in treating melanomas with BRAF mutations, while immune checkpoint inhibitors (e.g., nivolumab, pembrolizumab) have shown efficacy across various melanoma subtypes
  • References:
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Published by Rodrigo Arrangoiz MS, MD, FACS, FSSO

My name is Rodrigo Arrangoiz I am a breast surgeon/ thyroid surgeon / parathyroid surgeon / head and neck surgeon / surgical oncologist that works at Center for Advanced Surgical Oncology in Miami, Florida. I was trained as a surgeon at Michigan State University from (2005 to 2010) where I was a chief resident in 2010. My surgical oncology and head and neck training was performed at the Fox Chase Cancer Center in Philadelphia from 2010 to 2012. At the same time I underwent a masters in science (Clinical research for health professionals) at the University of Drexel. Through the International Federation of Head and Neck Societies / Memorial Sloan Kettering Cancer Center I performed a two year head and neck surgery and oncology / endocrine fellowship that ended in 2016. Mi nombre es Rodrigo Arrangoiz, soy cirujano oncólogo / cirujano de tumores de cabeza y cuello / cirujano endocrino que trabaja Center for Advanced Surgical Oncology en Miami, Florida. Fui entrenado como cirujano en Michigan State University (2005 a 2010 ) donde fui jefe de residentes en 2010. Mi formación en oncología quirúrgica y e n tumores de cabeza y cuello se realizó en el Fox Chase Cancer Center en Filadelfia de 2010 a 2012. Al mismo tiempo, me sometí a una maestría en ciencias (investigación clínica para profesionales de la salud) en la Universidad de Drexel. A través de la Federación Internacional de Sociedades de Cabeza y Cuello / Memorial Sloan Kettering Cancer Center realicé una sub especialidad en cirugía de cabeza y cuello / cirugia endocrina de dos años que terminó en 2016.

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