Molecular biology of melanoma

Biología molecular del melanoma

Introduction: Melanoma is an aggressive neoplasm with an increasing incidence in Colombia. Recent data reveal relevant differences in the distribution of its subtypes compared with international populations, with a higher frequency of acral lentiginous melanoma and lentigo maligna, suggesting the influence of genetic, environmental, or demographic factors specific to the Colombian population.

Objective: To describe the molecular alterations related to the pathogenesis of cutaneous melanoma, the current molecular classification system, including relevant co-mutations, as well as the pathophysiological mechanisms that support the use of therapeutic alternatives currently employed in cutaneous melanoma.

Methods: A literature review was conducted using databases such as PubMed, Embase, Scopus, Web of Science, and Google Scholar. Articles addressing the pathophysiological mechanisms underlying current molecular classification systems for melanoma, the most frequently reported mutations in human cutaneous melanoma, and predictors of response to targeted therapies were included.

Results: A total of 29 articles were selected describing the main molecular alterations in cutaneous melanoma, including mutations in genes involved in genomic regulation and metabolic response. A narrative synthesis of the alterations supporting oncogenesis, tumor progression, and mechanisms of therapeutic resistance is presented.

Conclusions: Cutaneous melanoma in Colombia exhibits clinical and epidemiological features that distinguish it from global patterns, with a predominance of the acral lentiginous subtype. While histological classification provides an initial approach to disease heterogeneity, the diversity of canonical and non-canonical mutations, as well as their impact on clinical behavior and therapeutic response, allows for a more accurate characterization of this complexity.