2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:Tb45,Solar factors play no role in the development of acral melanoma (AM). AM is characterized by low cumulative solar damage (low CSD). Responses to immunotherapy are correlated with mutational load, which, in turn, is correlated with high cumulative sun damage (CSD). This suggests that AM patients may have poor responses to immunotherapy. The clinical benefit and safety profile of adjuvant immunotherapies in AM treatment have not been fully investigated. To investigate whether the use of adjuvant immunotherapy for treating patients with AM in Stages IIb, IIc, III and IV NED (no evidence of disease) improves distant metastasis-free survival. Among the 1005 AM patients in the RIC-Mel melanoma database, 64 AM patients who were treated with adjuvant immunotherapy were included in this study. We then calculated a propensity score to make the adjuvant immunotherapy-treated (n = 64) group and the untreated group (n = 64) comparable in all respects. The use of adjuvant immunotherapy for treating AM offers no clear benefit in terms of relapse-free survival or distant metastasis-free survival (RFS: HR = 0.84 [0.534, 1.324, 95% CI] and DMFS: HR = 0.94 [0.565, 1.562, 95% CI]). Among the AM patients who received adjuvant immune checkpoint inhibitors (ICI), 18.8% experienced severe (Grades 3-4) immune-related adverse events. The benefit-risk balance must be carefully weighed, including the relapse-free survival (RFS), distant metastasis-free survival (DMFS) and rate of severe immune-related adverse events (irAE) occurrence. Other therapeutic strategies should be investigated in larger studies to confirm the potential limited clinical benefit of this treatment strategy. WHAT IS THE DISEASE?: Acral melanoma is a rare form of skin cancer that usually appears on the palms of the hands, soles of the feet or under the nails. Unlike most other melanomas, it is not linked to sun exposure. This research was carried out in France using information from a national melanoma database. We wanted to find out whether patients with acral melanoma benefit from adjuvant immunotherapy. This treatment, given after surgery, is designed to reduce the risk of the cancer returning. We studied 128 patients with acral melanoma. Half of them (64 patients) received immunotherapy, while the other half did not. The two groups were matched so that they could be fairly compared. The use of immunotherapy did not show a clear improvement in preventing the cancer from coming back or spreading to other parts of the body. In addition, almost 1 in 5 patients receiving immunotherapy experienced serious adverse events caused by the treatment. For people with acral melanoma, adjuvant immunotherapy may not provide significant benefit and carries a risk of severe adverse events. Doctors and patients should carefully weigh the advantages and risks before starting this treatment.31:Ta89,Abstract Background Solar factors play no role in the development of acral melanoma (AM). AM is characterized by low cumulative solar damage (low CSD). Responses to immunotherapy are correlated with mutational load, which, in turn, is correlated with high cumulative sun damage (CSD). This suggests that AM patients may have poor responses to immunotherapy. The clinical benefit and safety profile of adjuvant immunotherapies in AM treatment have not been fully investigated. Objectives To investigate whether the use of adjuvant immunotherapy for treating patients with AM in Stages IIb, IIc, III and IV NED (no evidence of disease) improves distant metastasis‐free survival. Methods Among the 1005 AM patients in the RIC‐Mel melanoma database, 64 AM patients who were treated with adjuvant immunotherapy were included in this study. We then calculated a propensity score to make the adjuvant immunotherapy‐treated ( n = 64) group and the untreated group ( n = 64) comparable in all respects. Results The use of adjuvant immunotherapy for treating AM offers no clear benefit in terms of relapse‐free survival or distant metastasis‐free survival (RFS: HR = 0.84 [0.534, 1.324, 95% CI] and DMFS: HR = 0.94 [0.565, 1.562, 95% CI]). Among the AM patients who received adjuvant immune checkpoint inhibitors (ICI), 18.8% experienced severe (Grades 3–4) immune‐related adverse events. Conclusions The benefit–risk balance must be carefully weighed, including the relapse‐free survival (RFS), distant metastasis‐free survival (DMFS) and rate of severe immune‐related adverse events (irAE) occurrence. Other therapeutic strategies should be investigated in larger studies to confirm the potential limited clinical benefit of this treatment strategy. 25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Acral Melanoma: condition Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Acral Melanoma (condition). Clinician-written summaries and actionable practice insights. 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Key details such as sample size, study design specifics, statistical results, and patient demographics could not be verified.","value_numeric":null},{"paper_doi":"10.1097/cmr.0000000000001130","tag_type":"warning","value":"Study design tag ('Biomarker Study') and level of evidence ('4') are inferred from the research framing and journal context; they may need revision upon full-text review.","value_numeric":null}],"summaries":{"what_studied":"This study evaluated NF1 gene alterations as a potential biomarker in acral melanoma, a subtype known for low tumor mutational burden (TMB), to identify actionable genomic markers beyond TMB.","key_result":"NF1 alterations were identified as a potentially relevant biomarker in acral melanoma, suggesting utility in stratifying patients who may benefit from targeted or immunotherapy approaches despite characteristically low TMB.","limitations":"The full text was not available for detailed extraction; specific sample size, statistical outcomes, and comparator groups could not be confirmed from the provided metadata alone.","practice_takeaway":"In acral melanoma patients with low TMB, testing for NF1 alterations may help identify a subgroup with actionable genomic changes. Clinicians should consider NF1 status as part of comprehensive molecular profiling in this melanoma subtype."}},{"doi":"10.1111/pcmr.70099","pmid":"42266021","title":"Integrative Single‐Cell and Bulk Transcriptomic Analysis Defines a Molecular Stratification Strategy Based on Intra‐Tumoral Heterogeneity in Acral Melanoma","journal_title":"Pigment Cell & Melanoma Research","journal_issn":"1755-1471","published_at":"2026-06-09T00:00:00.000Z","url":"https://doi.org/10.1111/pcmr.70099","source_score":2,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-18T13:24:26.521Z","updated_at":"2026-06-18T13:24:26.521Z","tags":[{"paper_doi":"10.1111/pcmr.70099","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1111/pcmr.70099","tag_type":"category","value":"Dermatology","value_numeric":null},{"paper_doi":"10.1111/pcmr.70099","tag_type":"condition","value":"Acral Melanoma","value_numeric":null},{"paper_doi":"10.1111/pcmr.70099","tag_type":"condition","value":"Melanoma","value_numeric":null},{"paper_doi":"10.1111/pcmr.70099","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1111/pcmr.70099","tag_type":"level_of_evidence","value":"4","value_numeric":null},{"paper_doi":"10.1111/pcmr.70099","tag_type":"modality","value":"Biomarker / Prognostic Scoring","value_numeric":null},{"paper_doi":"10.1111/pcmr.70099","tag_type":"sample_size","value":"n=23","value_numeric":23},{"paper_doi":"10.1111/pcmr.70099","tag_type":"study_design","value":"Integrative Transcriptomic Analysis (scRNA-seq + Bulk RNA-seq)","value_numeric":null},{"paper_doi":"10.1111/pcmr.70099","tag_type":"warning","value":"Sample size for scRNA-seq analysis is small (n=23), and the bulk RNA-seq cohort sizes are not specified in the abstract — absolute numbers for validation cohorts are unavailable.","value_numeric":null},{"paper_doi":"10.1111/pcmr.70099","tag_type":"warning","value":"Sex distribution of the study population is not reported in the abstract.","value_numeric":null},{"paper_doi":"10.1111/pcmr.70099","tag_type":"warning","value":"Study design is retrospective and computational; no experimental or clinical interventional validation is described.","value_numeric":null}],"summaries":{"what_studied":"This study analyzed intra-tumoral melanoma cell heterogeneity (ITMH) in acral melanoma (AM) using 23 samples across three scRNA-seq datasets, then validated a transcriptomic stratification method (ssGSEA-based scoring) in bulk RNA-seq cohorts to link heterogeneity with genomic, immunological, and clinical outcomes.","key_result":"High-ITMH (ITMHhi) AM tumors showed distinct molecular programs, greater genome instability, enriched progenitor-exhausted T cells, and an inflammatory TME compared to low-ITMH (ITMHlo) tumors; a hub-gene-based prognostic risk model derived from WGCNA and DEG analysis predicted patient survival in bulk RNA-seq cohorts.","limitations":"The scRNA-seq analysis relied on only 23 AM samples across three existing public datasets, limiting statistical power. The prognostic risk model was developed without prospective or independent clinical validation. AM is a rare subtype, so bulk RNA-seq cohort sizes are likely small.","practice_takeaway":"ITMH scoring may help stratify AM patients by prognosis and TME immune profile, but the model needs prospective validation before guiding treatment decisions. Clinicians should note that ITMHhi tumors appear to have a more exhausted, inflammatory microenvironment — potentially relevant when considering immunotherapy eligibility."}},{"doi":"10.1111/jdv.70136","pmid":"41277783","title":"Benefit of immune checkpoint inhibitors as adjuvant treatment for acral melanomas","journal_title":"Journal of the European Academy of Dermatology and Venereology","journal_issn":"0926-9959","published_at":"2025-11-24T00:00:00.000Z","url":"https://doi.org/10.1111/jdv.70136","source_score":4,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2025-11-24","doi":"10.1111/jdv.70136","days":"7","issn":"0926-9959","rank":"8","field":"Clinical Medicine","score":"4","category":"Dermatology","categories":["Dermatology"],"_categories":["Dermatology"]},"pubmed":{"doi":"10.1111/jdv.70136","title":"Benefit of immune checkpoint inhibitors as adjuvant treatment for acral melanomas.","journal":"Journal of the European Academy of Dermatology and Venereology : JEADV","methods":"","results":"The use of adjuvant immunotherapy for treating AM offers no clear benefit in terms of relapse-free survival or distant metastasis-free survival (RFS: HR = 0.84 [0.534, 1.324, 95% CI] and DMFS: HR = 0.94 [0.565, 1.562, 95% CI]). Among the AM patients who received adjuvant immune checkpoint inhibitors (ICI), 18.8% experienced severe (Grades 3-4) immune-related adverse events.","abstract":"$30","keywords":["adjuvant drug therapy","foot","hand","immune checkpoint inhibitors","melanoma","nivolumab","pembrolizumab","recurrence"],"pubmed_id":"41277783","conclusions":"","publication_date":"2025-11-24T00:00:00"},"crossref":{"DOI":"10.1111/jdv.70136","URL":"https://doi.org/10.1111/jdv.70136","ISSN":["0926-9959","1468-3083"],"link":[{"URL":"https://onlinelibrary.wiley.com/doi/pdf/10.1111/jdv.70136","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":null,"type":"journal-article","issue":null,"score":1,"title":["Benefit of immune checkpoint inhibitors as adjuvant treatment for acral melanomas"],"author":[{"given":"Damien","family":"Sanogo","sequence":"first","affiliation":[{"name":"UNICAEN, INSERM U1086 ANTICIPE, Biology Research Building Normandy University Caen 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Melanoma","value_numeric":null},{"paper_doi":"10.1111/jdv.70136","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1111/jdv.70136","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1111/jdv.70136","tag_type":"modality","value":"Immune Checkpoint Inhibitor","value_numeric":null},{"paper_doi":"10.1111/jdv.70136","tag_type":"sample_size","value":"n=128","value_numeric":128},{"paper_doi":"10.1111/jdv.70136","tag_type":"study_design","value":"Cohort","value_numeric":null},{"paper_doi":"10.1111/jdv.70136","tag_type":"warning","value":"Design is an observational, propensity score–matched registry analysis, not randomized.","value_numeric":null},{"paper_doi":"10.1111/jdv.70136","tag_type":"warning","value":"Follow-up duration and absolute event counts were not reported.","value_numeric":null},{"paper_doi":"10.1111/jdv.70136","tag_type":"warning","value":"Immunotherapy agents and dosing regimens were not specified in the provided text.","value_numeric":null}],"summaries":{"what_studied":"A propensity score–matched analysis from a French national melanoma database compared adjuvant immune checkpoint inhibitors versus no adjuvant therapy in acral melanoma stages IIb, IIc, III, and IV NED (64 treated vs 64 untreated).","key_result":"Adjuvant therapy showed no clear benefit for relapse-free survival (HR 0.84, 95% CI 0.534–1.324) or distant metastasis-free survival (HR 0.94, 95% CI 0.565–1.562); 18.8% of treated patients had grade 3–4 immune‑related adverse events.","limitations":"Retrospective registry study with a small treated cohort (n=64) despite matching; follow-up duration and absolute event counts were not reported.","practice_takeaway":"In resected acral melanoma across these stages, adjuvant immune checkpoint inhibition did not improve RFS or DMFS in this matched cohort, while nearly 1 in 5 experienced severe irAEs; weigh risks and benefits and consider alternative strategies or clinical trials."}}],"initialOffset":3,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"condition","value":"Acral Melanoma"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Conditions","href":"/hub/tag/condition"},{"name":"Acral Melanoma"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"condition","hub_tag_value":"Acral Melanoma"}}}]]

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