Cutaneous melanoma

27-Hydroxycholesterol in cancer development and drug resistance

27-Hydroxycholesterol (27HC), a cholesterol metabolite, functions both as a selective oestrogen receptor (ER) modulator and a ligand for liver X receptors (LXRs). The discovery of 27HC involvement in carcinogenesis has unveiled new research avenues, yet its precise role remains controversial and context-dependent. In this review, we provide an overview of the biosynthesis and metabolism of 27HC and explore its cancer-associated signalling, with a particular focus on ER- and LXR-mediated pathways. Given the tissue-specific dual role of 27HC, we discuss its differential impact across various cancer types. Furthermore, we sort out 27HC-contributed drug resistance mechanisms from the perspectives of drug efflux, cellular proliferation, apoptosis, epithelial-mesenchymal transition (EMT), antioxidant defence, epigenetic modification, and metabolic reprogramming. Finally, we highlight the chemical inhibitors to mitigate 27HC-driven cancer progression and drug resistance. This review offers an updated role of 27HC in cancer biology, setting the stage for future research and the development of targeted therapeutics.

Research hotspots and trends of immunotherapy and melanoma: A bibliometric analysis during 2014-2024

Over the last decade, the increasing global prevalence of melanoma has sparked growing interest in immunotherapies, which show significant potential against this form of skin cancer. This research aims to offer a framework to guide future studies and inspire new research directions. In this study, we used the Web of Science Core Collection to collect papers on immunotherapy and melanoma published between 2014 and 2024. With Excel and visualization tools like VOSviewer, COOC 13.2, Citespace, and Bibliometrix (R-Tool of R-Studio), we analyzed the data to spot trends and new focuses in the research. Our findings indicate a substantial surge in research activity concerning immunotherapy and melanoma between 2014 and 2024. The USA and China emerged as leading contributors, engaging in extensive and close collaborative efforts with European counterparts. Furthermore, seven of the top 10 research institutions are located in the USA, with the MD Anderson Cancer Center in Texas being the most productive. In addition, the Journal of Cancer Immunotherapy is the journal with the most articles published in the field. Professor Georgina V. Long from the Melanoma Institute at the University of Sydney was one of the most productive scholars. Keyword analysis shows that immune checkpoint inhibitors, tumor microenvironment and targeted therapies are key areas of interest for the research community. This paper uses bibliometric analysis to outline research trends and key points in immunotherapy and melanoma from 2014 to 2024, which helps understand the current research and guides future research directions.

Efficacy and safety of adjuvant systemic therapies in trial non-eligible resected stages III and IV melanoma patients

BACKGROUND

Adjuvant immunotherapy and targeted therapy are now the standard of care for patients with resected stage IIIA-IV melanoma. However, little is known regarding its efficacy in real-world patients who were not represented in these landmark trials.

METHODS

This retrospective study included all patients with resected stage IIIA-IV melanoma who received adjuvant systemic therapy between January 1 2018 and December 31 2020, in two Canadian academic cancer. Primary outcome was the proportion of trial non-eligible patients in the real-world setting. Survival and safety analyses were also conducted.

RESULTS

Of the total 113 patient, 99 (88%) were trial non-eligible patients. Most common reasons for trial non-eligible criteria was having no baseline CLND (72%), followed by outside of treatment window >12 weeks (30%), stage IIIA (14%), unknown primary (9%), stage IV (14%), and baseline AD on immunosuppressants (3%). There were no significant RFS (P = 0.731) or OS (P = 0.110) differences in the overall population of trial eligible vs. non-eligible. Safety profiles were similar between the trial eligible vs. non-eligible groups.

CONCLUSION

Our study suggested a high proportion of real-world patients would have been deemed non-eligible for clinical trials. Regardless, adjuvant systemic therapy delivered similar survival and toxicity outcomes in both groups.

Gut microbiota in melanoma: Effects and pathogeneses

The gut microbiota exhibits intricate connections with the body's immune system and holds significant implications for various diseases and cancers. Currently, accumulating evidence suggests a correlation between the composition of the gut microbiota and the development, treatment, and prognosis of melanoma. However, the underlying pathogenesis remains incompletely elucidated. In this comprehensive review, we present an in-depth review of the role played by gut microbiota in melanoma tumorigenesis, growth, metastasis, treatment response, and prognosis. Furthermore, we discuss the potential utility of gut microbiota as a promising prognostic marker. Lastly, we summarize three routes through which gut microbiota influences melanoma: immunity, aging, and the endocrine system. By modulating innate and adaptive immunity in patients with melanoma across different age groups and genders, the gut microbiota plays a crucial role in anti-tumor immune regulation from tumorigenesis to prognosis management, thereby impacting tumor growth and metastasis. This review also addresses current study limitations while highlighting future research prospects.

Astragalus injection antagonizes the efficacy of anti-PD-1 against melanoma through down-regulating MHC-II expression

ETHNOPHARMACOLOGICAL RELEVANCE

Astragalus injection, a solution derived from Astragalus mongholicus Bunge, has been used in cancer patients for its immune-boosting properties. The effects of Astragalus injection combined with immune checkpoint inhibitors (ICIs) in cancer remain unsuspected.

AIM OF THE STUDY

This study aims to investigate the efficacy of combining Astragalus injection with anti-PD-1 and to elucidate the potential mechanisms.

MATERIALS AND METHODS

A melanoma-bearing mouse model was established to observe the effects of Astragalus injection combined with anti-PD-1 treatment. The immune cell infiltration in tumor tissues was evaluated by flow cytometry. Subsequently, network pharmacology and RNA sequencing were conducted to anticipate latent mechanisms of Astragalus in melanoma. Finally, these predictions were validated by flow cytometry, qPCR, Western blotting, and ELISA.

RESULTS

Astragalus injection significantly antagonized the efficacy of anti-PD-1 in melanoma, resulting in a notable reduction of immune cell infiltration. The network pharmacology and RNA sequencing analysis revealed critical signaling routes, encompassing T-cell receptor activation, immune antigen presentation, and the JAK/STAT pathway. Subsequent data suggested that Astragalus injection could down-regulate the expressions of MHC-II in dendritic cells and B16-OVA cells and restrict the activation of dendritic cells. Moreover, the expressions of CIITA and phosphorylated STAT1 were prominently inhibited by Astragalus injection, whereas the overexpression of STAT1 partially reversed the Astragalus injection-induced decrease of MHC-II.

CONCLUSIONS

Astragalus antagonized the therapeutic effect of anti-PD-1 in melanoma. These effects were partially through inhibiting JAK/STAT signaling and down-regulating MHC-II expression.

Incidence and survival of patients with melanoma in Colombia

BACKGROUND

Melanoma accounts for less than 2 % of all skin cancers but exhibits highly aggressive behaviour, rapidly leading to metastasis. Various individual and environmental risk factors are associated with its occurrence.

METHODS

A cohort study was conducted using data from the Integrated Social Protection Information System (SISPRO) of the Colombian Ministry of Health. Patients with newly diagnosed melanoma in 2019 were included. Demographic, clinical, and mortality characteristics were analysed, and crude and age- and sex-adjusted incidence rates were calculated. The association between the altitude of populations and melanoma rates was evaluated using Pearson's correlation coefficient and an analysis of variance. The Fine and Gray model was used to estimate survival.

RESULTS

In 2019, 5255 new cases of melanoma were reported in the health insurance system. The crude incidence rate was 22 cases per 100,000 inhabitants, and the age-adjusted incidence rate was 21. The overall three-year mortality rate was 18.8 %, with melanoma-attributable mortality at 7 %. As expected, the mortality rate was higher in patients with invasive melanoma, COPD, and among men. Melanoma rates were positively correlated with greater exposure to UV radiation, determined by the altitude of the municipalities.

CONCLUSION

Colombia has high melanoma incidence rates, with significant regional variations. UV radiation exposure and altitude are key factors.

Precision targeted melanoma therapy via cuproptosis/chemodynamic and chemotherapy: An engineering MCHS-CuMOF nanodelivery system

Melanoma, a highly aggressive skin cancer, continues to challenge current therapeutic modalities due to its resistance and high mortality rates. Recent advancements highlight cuproptosis, a copper-driven form of programmed cell death, as a promising target for melanoma treatment. This study integrated machine learning and large-scale genomic data to identify FDX1 as a pivotal gene in cuproptosis-related pathways for melanoma. We developed a novel nanomedicine, ACM@MCHS-CuMOF@Dox, combining Mesoporous Carbon Hollow Spheres (MCHS) loaded with Copper-based Metal-Organic Frameworks (CuMOFs) and Doxorubicin (Dox), to exploit this discovery. The nanomedicine leverages a biomimetic approach by incorporating A375 cell membranes, enhancing tumor-targeted delivery. Physicochemical characterization confirms optimal drug loading and pH/GSH-responsive release profiles. In vitro studies demonstrate that ACM@MCHS-CuMOF@Dox inhibits melanoma cell proliferation, migration, and invasion, outperforming other formulations. Mechanistic investigations revealed that ACM@MCHS-CuMOF@Dox induced robust apoptosis and cuproptosis through FDX1 downregulation, thereby enhancing oxidative stress and therapeutic efficacy. These findings underscore the potential of combining machine learning-driven target identification with advanced nanomedicine for precision melanoma therapy. This approach offers a promising strategy for overcoming current treatment limitations and advancing personalized cancer care.

VSV-CHIKV activates antitumor immunity by inducing pyroptosis in a melanoma model

Melanoma is the most dangerous skin cancer due to its difficulty in treatment, high recurrence rate and metastatic ability. As a vector for oncolytic viruses (OVs), vesicular stomatitis virus (VSV) has been shown to be effective against malignant melanoma. However, the glycoprotein G protein of VSV has potential neurotoxicity. It has been shown that replacing glycoprotein G with E3-E2-6K-E1 of chikungunya virus (CHIKV) reduces its neurotoxicity and targets gliomas. Therefore, the aim of this study was to investigate the oncolytic effect of recombinant VSV-CHIKV on melanoma and the underlying mechanism. In this study, we found that recombinant VSV-CHIKV triggered GSDMD-mediated melanoma cell pyroptosis. Importantly, the NLRP3/Caspase-1/GSDMD axis was activated after VSV-CHIKV infection in melanoma cell lines and in a xenograft mouse model. Inhibition of GSDMD blocked cell pyroptosis, antitumor immunity and the tumor response in response to VSV-CHIKV treatment, suggesting that VSV-CHIKV act through the GSDMD pathway. VSV-CHIKV-triggered GSDMD-mediated tumor pyroptosis recruited cytotoxic T lymphocytes (CTLs) into the tumor microenvironment, which was accompanied by the release of inflammatory mediators. This remodeled the tumor microenvironment and turned immunologically "cold" tumors into "hot" tumors, thereby sensitized these tumors to checkpoint blockade. Finally, the combination therapy of VSV-CHIKV and an immune checkpoint inhibitor (anti-PD-1) prolonged the survival of mice. In conclusion, the VSV-CHIKV strategy is an attractive biologic therapy against melanoma.

KS-NailMel-1: a novel cell line of nail apparatus melanoma

Nail apparatus melanoma (NAM) is a specific type of cutaneous melanoma that develops in the nail apparatus of the hands and feet. The prognosis for metastatic NAM is poor due to a lack of fully effective systemic therapies. However, the difficulty in obtaining a NAM model has hindered basic research aimed at discovering effective treatment strategies. In this study, we established a NAM cell line, named KS-NailMel-1, from a primary tumor located on the nail apparatus of the left ring finger of a 68-year-old Japanese female. The cells were successfully maintained for over 9 months, exhibiting a doubling time of 38.6 ± 1.94 h. KS-NailMel-1 displayed consistent growth, spheroid formation, and invasiveness, and was confirmed to be identical to the original tumor through short tandem repeat analyses, whole-exome sequencing, and immunohistochemistry. Western blotting of the cells demonstrated the protein expression of NECTIN4, which has recently attracted attention as a potential therapeutic target for melanoma. The KS-NailMel-1 cell line represents a valuable resource for basic and preclinical research on NAM, deepening our understanding of the tumor characteristics and facilitating the development of treatment strategies for this rare form of cancer.

USP41 plays carcinogenic roles in human cutaneous melanoma through PI3K/Akt signaling pathway

Cutaneous melanoma is a malignant tumor with a high mortality rate. Ubiquitin-specific protease 41 (USP41) has recently been reported to be overexpressed in various malignancies. However, its role in melanoma remains unclear. Gene Expression Profiling Interactive Analysis (GEPIA) was used to perform pan-cancer analysis using data from the the Cancer Genome Atlas (TCGA) and the Genotype-Tissue Expression (GTEx) databases. Melanoma tissue microarray (TMA), clinical patient tissues, and cells were used to explore USP41 expression profiles by immunohistochemistry (IHC), RT-qPCR or Western blotting. Small interfering RNAs (siRNAs) were used to knock down USP41 in melanoma cells. Cell proliferation, migration, and invasion were assessed using CCK-8, EdU staining, wound healing, and transwell assays, respectively. Cell apoptosis was detected by flow cytometry and TUNEL staining. GEPIA revealed that USP41 is highly expressed in most human cancers, including melanoma. USP41 is overexpressed in melanoma tumor tissues and cells. IHC showed that USP41 was positively stained in melanoma tissues and was significantly correlated with the TNM stage of melanoma. USP41 knockdown inhibited cell proliferation, migration, and invasion while promoting cell apoptosis and inhibiting phosphorylated PI3K, AKT, and mTOR in the PI3K/AKT signaling pathway. The results indicate that USP41 may play a carcinogenic role in melanoma partly via the PI3K/AKT signaling pathway, suggesting that USP41 may be an effective therapeutic target for the treatments of cutaneous melanoma.

Randomized, Open-Label, Phase III Study of Tilsotolimod in Combination With Ipilimumab Versus Ipilimumab Alone in Patients With Advanced Refractory Melanoma (ILLUMINATE-301)

PURPOSE

There are limited treatment options for advanced melanoma that have progressed during or after immune checkpoint inhibitor therapy. Intratumoral (IT) immunotherapy may improve tumor-specific immune activation by promoting local tumor antigen presentation while avoiding systemic toxicities. The phase 3 ILLUMINATE-301 study (ClinicalTrials.gov identifier: NCT03445533) evaluated tilsotolimod, a Toll-like receptor-9 agonist, with or without ipilimumab in patients with anti-PD-1 advanced refractory melanoma.

METHODS

Patients with unresectable stage III-IV melanoma that progressed during or after anti-PD-1 therapy were randomly assigned 1:1 to receive 24 weeks of tilsotolimod plus ipilimumab or 10 weeks of ipilimumab alone. Nine IT injections of tilsotolimod were administered to a single designated lesion over 24 weeks. Intravenous ipilimumab 3 mg/kg was administered once every 3 weeks from week 2 in the tilsotolimod arm and week 1 in the ipilimumab arm. The primary end point was efficacy measured using objective response rate (ORR; independent review) and overall survival (OS).

RESULTS

A total of 481 patients received tilsotolimod plus ipilimumab (n = 238) or ipilimumab alone (n = 243). ORRs were 8.8% in the tilsotolimod arm and 8.6% in the ipilimumab arm, with disease control rates of 34.5% and 27.2%, respectively. Median OS was 11.6 months in the tilsotolimod arm and 10 months in the ipilimumab arm (hazard ratio, 0.96 [95% CI, 0.77 to 1.19]; P = .7). Grade ≥3 treatment-emergent adverse events occurred in 61.1% and 55.5% of patients in the tilsotolimod and ipilimumab arms, respectively.

CONCLUSION

Combining IT tilsotolimod with ipilimumab did not significantly improve the ORR or OS compared with ipilimumab alone in patients with anti-PD-1 advanced refractory melanoma.

Stellate silicon microneedles for rapid point-of-care melanoma exosome isolation and detection via a lateral flow assay

Melanoma is the most aggressive type of skin cancer with high mortality rates. Early diagnosis is crucial because it significantly improves treatment outcomes, but conventional methods relying on dermoscopy and lesion biopsy have limitations in accuracy during early stages and are invasive. Liquid biopsies offer a minimally invasive alternative, particularly for routine screening. The abundance of cancer cell-driven extracellular vesicles in interstitial fluid can be utilized for point-of-care cancer diagnostics. Here, we developed a stellate silicon microneedle patch, the ExoPatch, coated with Annexin V functionalized hydrogel to isolate melanoma-specific exosomes. The ExoPatch captures exosomes directly from the skin, followed by dissolution of the hydrogel to release the exosomes, which are then detected using a lateral flow immunoassay specific to melanoma markers (MCAM and MCSP). After validating with cell line derived extracellular vesicles and testing with mouse tissue, the ExoPatch isolated 11.5 times more protein from melanoma tissue compared to healthy tissue. Additionally, the ExoPatch effectively distinguished between melanoma and healthy tissues, with its specificity confirmed through Western Blot and electron microscopy analysis. The ExoPatch with melanoma mouse samples produced a 3.5-fold higher signal in the lateral flow immunoassay compared to that of healthy controls. The ExoPatch presents a promising point-of-care diagnostic tool for melanoma, offering significant advantages in terms of rapidness, minimal invasiveness, and ease of use. It has the potential to enhance early detection and routine monitoring in melanoma patients, ultimately improving patient outcomes by reducing the reliance on traditional, invasive biopsies.

Research Progress of Natural Compounds from Chinese Herbal Medicine in the Treatment of Melanoma

OPINION STATEMENT

Melanoma is a malignant tumor that originates from activated or genetically altered epidermal melanocytes, resulting from the interplay of genetic, somatic, and environmental factors. It is the fastest-growing malignancy among the Caucasian population and has a high mortality rate, second only to lung cancer. Current mainstream treatments have led to unavoidable drug resistance and toxic side effects despite improvements in efficacy and prognosis. Traditional Chinese Medicine is a significant component of complementary and alternative medicine, playing a vital role in cancer treatment. Natural compounds derived from Chinese herbal medicines offer notable advantages owing to their multimolecular, multitarget, and multipathway characteristics. These compounds exert anti-melanoma effects through various mechanisms, including antiproliferation, promotion of apoptosis, inhibition of metastasis, suppression of angiogenesis, modulation of autophagy, and enhancement of the immune response. Furthermore, combining natural compounds with mainstream antagonistic medicine not only enhances treatment efficacy but also significantly reverses multidrug resistance. This article discusses the specific mechanisms by which natural compounds combat melanoma and reviews the recent research advancements in this field. It also addresses the challenges faced in the widespread clinical application of these natural compounds in melanoma treatment and outlines the future directions for their development.

Epigenetic Therapies in Melanoma-Targeting DNA Methylation and Histone Modification

Skin cancer prevalence has increased during the last decades, with the last years serving as a pivotal moment for comprehending its epidemiological patterns and its impact on public health. Melanoma is one of the most frequently occurring malignancies, arising from a complex interplay of genetic factors, environmental factors, lifestyle and socio-economic conditions. Epigenetic changes play a critical role in tumor development, influencing progression and aggressiveness. Epigenetic therapies could represent novel therapeutic options, while drug repositioning may serve as a viable strategy for cancer treatment. Demethylating agents, commonly used in hematological malignancies, show promising results on solid tumors, including melanoma. Methylation patterns are responsible for tumor development by modulating gene expression, while histone acetylation influences DNA processes such as transcription, replication, repair, and recombination. This review aims to identify existing potential therapeutical approaches using therapeutic agents that can modulate DNA methylation and histone modification, which can lead to tumor inhibition, cell death initiation and reactivation of tumor suppressor genes.

Micronutrients and skin cancer risk: a Mendelian randomization study

BACKGROUND

The intake of micronutrients is linked to cancer risk, but their specific mechanisms in skin cancer remain unclear. This study systematically investigated the causal effects of 15 micronutrients on non-melanoma skin cancer (NMSC) and malignant melanoma (MM) using Mendelian Randomization (MR).

METHODS

Genetically predicted levels of 15 micronutrients served as instrumental variables in a two-sample MR analysis, utilizing data from the Finnish FinnGen database (version R10). To address potential horizontal pleiotropy and heterogeneity, sensitivity analyses included inverse-variance weighted (IVW), weighted median, MR Egger regression, and MR PRESSO. The study analyzed data from 650,657 European participants, including 19,077 NMSC and 3,194 MM cases.

RESULTS

Selenium (p = 0.0001, OR 0.788, 95% CI 0.703-0.883) and Potassium (p = 0.045, OR 0.463, 95% CI 0.219-0.982) were significantly negatively associated with MM risk, suggesting a protective effect. Conversely, Calcium (p = 0.025, OR 1.257, 95% CI 1.030-1.534) was positively associated with NMSC risk, indicating it may be a risk factor. Vitamin B6 (p = 0.004, OR 0.741, 95% CI 0.604-0.909) also showed a significant protective effect against NMSC.The remaining 11 micronutrients showed no significant causal association with NMSC or MM (p > 0.05).

CONCLUSIONS

This study highlights that Selenium and Potassium may protect against MM, while Calcium increases NMSC risk, with Vitamin B6 providing protection against NMSC. These findings enhance our understanding of micronutrients in skin cancer mechanisms and inform potential prevention strategies.

Polypyrrole modified hFGF2-oil bodies for postsurgical melanoma recurrence suppression and wound healing acceleration

Surgical treatment is the primary method for treating malignant melanoma at present. However, tumor recurrence after surgery and difficulty in wound healing remain significant challenges. This study designed and constructed a therapeutic wound dressing by loading polypyrrole (PPy) into human fibroblast growth factor 2 (hFGF2) covalently bonded camelina oil bodies (h-OB) to form Ph-OB. In a postoperative B16F10 melanoma model in C57BL/6 mice, the photothermal properties of PPy were utilized to increase the temperature at the surgical wound site through near-infrared light irradiation, performing photothermal therapy to kill residual tumors and inhibit tumor recurrence. Meanwhile, the release of hFGF2 from the Ph-OB acts on the postoperative wound site, promotes fibroblast proliferation and migration to accelerate wound healing. In summary, the developed Ph-OB not only prevents tumor recurrence but also facilitates the healing of surgery-induced wounds, showing great potential in postoperative cancer treatment.

Long-Term Evaluation of Patients With Clinical Node-Negative Malignant Melanoma: A Tertiary Single Center Experience

IntroductionWe aimed to investigate the prognostic factors for patients with cutaneous malignant melanoma undergoing sentinel lymph node biopsy.Materials and MethodsPatients who underwent sentinel lymph node biopsy between January 2004 and December 2019 were reviewed retrospectively. Demographic characteristics, tumor location, thickness and other histopathological features, number and status of lymph nodes removed in SLNB, results of elective lymph node dissection in SLNB-positive patients, distant and local metastases, mortality, and follow-up periods were recorded.ResultsThere were 222 patients, 96 females, with an age range of 54.25 ± 16.34 years. Mean tumor thickness was 3.65 ± 2.87 mm. Disease-free survival was calculated as 78.4 ± 56.79 months. Sixty-five patients (29.2%) had positive sentinel lymph node biopsies. Recurrence, defined as local, regional, or distant metastasis, mortality and mortality and/or recurrence was observed in 14.4%, 20.7% and 29.7% of patients, respectively. Sex, tumor thickness, presence of comorbidities, ulceration, and positive sentinel lymph nodes were found to be independent risk factors affecting mortality. Presence of ulceration and lymphatic invasion were independent risk factors for recurrence. Tumor thickness >2 mm led to a significantly shorter survival than the ones with tumor thickness <2 mm.ConclusionThe 5-year survival rate for malignant melanoma was found to be significantly higher in comparison to other studies in the literature. Additionally, acral lentiginous melanoma exhibited a significantly higher prevalence compared to nodular melanoma.

Early switch from run-in with targeted to immunotherapy in advanced BRAFV600-positive melanoma: final results of the randomised phase II ImmunoCobiVem trial

BACKGROUND

Optimal sequencing of immune checkpoint inhibitors (ICIs) and targeted therapies (TTs) in BRAFV600-positive advanced melanoma should achieve rapid tumour control and durable progression-free survival (PFS), translating into prolonged overall survival (OS).

PATIENTS AND METHODS

The 1 : 1 randomised phase II ImmunoCobiVem trial compared-after a 3-month run-in phase with vemurafenib (VEM, 960 mg twice daily) and cobimetinib (COB, 60 mg daily days 21-28, q4w)-continuous VEM + COB until disease progression (PD1) and second-line atezolizumab (ATEZO, 1200 mg, q3w) in arm A versus early switch to ATEZO after run-in, followed by crossover to VEM + COB at PD1, in arm B. PFS from the start of run-in until PD1 was the primary endpoint (PFS1); secondary efficacy endpoints were OS, overall PFS (PFS2) and PFS3 (time from PD1 to PD after crossover, i.e. PD2) and best overall response rates (BORRs).

RESULTS

The final analysis (median follow-up 57.0 months, interquartile range 22.7-63.0 months) confirmed longer PFS1 for continuous TT [arm A (69 patients) versus arm B (early switch, 66 patients); hazard ratio (HR) 0.61, 95% confidence interval (CI) 0.41-0.91, P = 0.006], but early switch to ICIs resulted in better long-term OS [4- and 5-year landmark OS 42% (95% CI 29% to 55%) and 40% (95% CI 27% to 53%) for arm A, and 53% (95% CI 38% to 65%) and 45% (95% CI 31% to 58%) for arm B; descriptive HR 1.17, 95% CI 0.71-1.91]. Absolute BORRs were 81% and 89%, respectively, with 15 (22%) and 19 (29%) patients achieving a complete response at least once along each sequence. At crossover, TT retreatment (arm B) resulted in higher PFS3 than second-line ICI (arm A).

CONCLUSIONS

Early switch to ICIs after TT run-in (arm B) led to an improved, although not statistically significant, 4- and 5-year landmark OS compared with arm A. No subgroups were identified for which a TT run-in provided clinical benefit. The number of patients developing brain metastasis and the time to brain metastasis were not improved by an early TT to ICI switch.

Exosome/liposome hybrid nanovesicles for enhanced phototherapy and boosted anti-tumor immunity against melanoma

Although phototherapy shows great potential as a safe ablative modality for treatment of cutaneous melanoma, there remain serious flaws restricting its therapeutic outcomes, such as cellular resistance against apoptosis, tumor hypoxia, rewritten cellular metabolism and abnormal angiogenesis. To cope with these challenges, this work combines hemin and IR780 (phototherapy agent) and designs an orchestrated liposome/macrophage-derived exosome hybrid delivery system (named IHEL) for tumor-specific delivery of these two drugs and synchronous tumor microenvironment (TME) reprogramming. As the experimental data suggest, by triggering iron overload and up-regulating HMOX-1, hemin drives a shift from an apoptosis-dominant anti-cancer mode to a combined ferroptosis/apoptosis mode of IR780 treatment, which helps to avoid apoptosis resistance. Also, the catalase-like activity of hemin strengthens PDT effect by alleviating hypoxia. In addition to the above-mentioned enhanced direct cell-killing effect, IHEL also provokes anti-cancer immunity by triggering immunogenic cell death (ICD), intervening glycometabolism and polarizing tumor-associated macrophages (TAMs) in TME to M1-type. This work strongly demonstrated the rationality of IR780/hemin combination and delicately designed immunostimulatory nanocarriers for their tumor-specific delivery, providing both theoretical foundation and practical strategies for advanced anti-cancer phototherapy.

Tessaria absinthioides (Hook. & Arn.) DC. Determines Inhibition of Tumor Growth and Metastasis In Vitro and In Vivo in Murine Melanoma

Melanoma is one of the deathliest cancers worldwide and its incidence is reaching epidemic proportions. It is characterized by intrinsic chemo-resistance, low response rates to treatment and high metastatic potential. Because of this, new therapeutic options are permanently required. Tessaria absinthioides (Hook. & Arn.) DC. is a traditional medicinal plant, with antioxidant, selective cytotoxicity and anti-colorectal cancer evidence-based properties. This study aims to demonstrate the antitumoral and antimetastatic effects of T. absinthioides decoction (DETa), correlating in vitro and in vivo activities in a murine melanoma model. DETa was assayed on B16F0 murine non-metastatic cells to determine cytotoxicity and clonogenicity; while, in the B16F10 metastatic siblings, adhesion, wound healing migration and Boyden chamber invasion were studied. The ex vivo intestinal-sac model was used to quantify DETa bioavailability. Meanwhile, in C57BL6/wt mice, DETa was orally administered to evaluate its antitumoral and antimetastatic activities. DETa induced cytotoxicity in a dose- and time-dependent manner, affecting the long-term clonogenic survival, as well as the processes of adhesion and migration. Then, the intestinal absorption of DETa phenolics was proven, while the systemic anti-tumoral and anti-metastatic activities of DETa were confirmed. Results demonstrated that DETa has antimelanoma activity promoting this botanical compound as a relevant agent for cancer research and treatment.

Reconsidering the surgical approach in cutaneous melanoma: does wide local excision after a complete diagnostic excision reduce the risk of recurrence?

OBJECTIVES

This study examines whether wide local excision (WLE) after complete diagnostic excision improves recurrence-free survival (RFS) in clinical stage I/II primary cutaneous melanoma.

BACKGROUND

Since the 1950s, melanoma treatment has included a two-step surgical approach, involving diagnostic excision followed by WLE. WLE aims to achieve locoregional disease control by eliminating potential microsatellites and, thus, minimising the risk of locoregional recurrence and melanoma-related death. However, its impact on RFS is unclear, while it adds morbidity and costs.

METHODS

This retrospective nationwide cohort study analysed pathology reports of a Dutch population-based cohort of newly diagnosed invasive cutaneous melanoma patients who underwent a complete diagnostic excision between January 1st, 2012, and December 31st, 2013. Data were obtained from the Dutch Nationwide Pathology Database (PALGA). Patients with completely excised superficial spreading and nodular melanoma located on the trunk and upper and lower extremities were included. Cox regression showed no significant RFS benefit from WLE.

RESULTS

A total of 6189 eligible patients were included. WLE was not performed in 271 patients (4.4 %). Of those undergoing WLE (n = 5918), residual dermal invasive tumour cells were identified in 0.7 % (n = 44/5918). The overall recurrence rate was 7.7 % (n = 477/6189). Recurrence rates were 7.6 % for WLE cases (local: 2.5 %, nodal: 4.0 %, distant: 1.2 %) and 10.3 % when WLE was omitted. Cox regression showed no significant RFS benefit from WLE.

CONCLUSION

WLE does not significantly improve RFS in patients with completely excised cutaneous superficial spreading and nodular melanoma on the trunk or extremities.

The prognostic value of halp score in predicting the efficacy of nivolumab treatment in metastatic malignant melanoma patients: A real-life, retrospective, single center analysis

Patients with metastatic malignant melanoma have a survival rate of less than one year. Nivolumab, a monoclonal antibody against programmed cell death 1 (PD-1) receptor, has improved survival in patients without BRAF mutations. The HALP score, calculated from hemoglobin, albumin, lymphocyte, and platelet levels, provides information about a patient immune and nutritional status. High HALP scores have been associated with a better prognosis in various cancers. This study aimed to investigate the effect of high HALP scores on response to nivolumab treatment in patients with metastatic malignant melanoma. A retrospective study was conducted on 44 patients with metastatic malignant melanoma treated with nivolumab at Adana City Training and Research Hospital between 2014 and 2021. Patients who received dabrafenib-trametinib before nivolumab treatment were excluded. The HALP scores were calculated using laboratory parameters before the first nivolumab treatment. Statistical analyses were performed using SPSS version 25.0. The study included 22 female and 22 male patients with a mean age of 61.4 ± 15.6 years. Of the patients, 10 (27.2%) had a positive BRAF mutation, whereas 34 (77.3%) did not. The HALP score cutoff value was determined as 30.1. Patients with high HALP scores had significantly longer progression-free survival (PFS) and overall survival (OS) compared to those with low HALP scores (PFS: median 5.8 vs 3.1 months, P = .041; OS: median 54.9 vs 14.4 months, P = .005). In this study, we found that high HALP scores were significantly associated with longer PFS and OS in metastatic malignant melanoma patients receiving nivolumab treatment. HALP score was associated with both PFS and OS in patients with metastatic malignant melanoma treated with nivolumab. This immuno-nutritional parameter may be useful in various cancers; however, further prospective studies with larger patient cohorts are needed for clinical application.

Rewiring lipid metabolism to enhance immunotherapy efficacy in melanoma: a frontier in cancer treatment

Immunotherapy has transformed the landscape of melanoma treatment, offering significant extensions in survival for many patients. Despite these advancements, nearly 50% of melanoma cases remain resistant to such therapies, highlighting the need for novel approaches. Emerging research has identified lipid metabolism reprogramming as a key factor in promoting melanoma progression and resistance to immunotherapy. This reprogramming not only supports tumor growth and metastasis but also creates an immunosuppressive environment that impairs the effectiveness of treatments such as immune checkpoint inhibitors (ICIs). This review delves into the intricate relationship between lipid metabolism and immune system interactions in melanoma. We will explore how alterations in lipid metabolic pathways contribute to immune evasion and therapy resistance, emphasizing recent discoveries in this area. Additionally, we also highlights novel therapeutic strategies targeting lipid metabolism to enhance immune checkpoint inhibitor (ICI) efficacy.

Construction of In Situ Personalized Cancer Vaccines by Bioorthogonal Catalytic Microneedles for Augmented Melanoma Immunotherapy

In situ personalized tumor vaccines are produced directly at the primary tumor site by killing cancer cells and stimulating immune cells, they are effective against individuals and bypass the complexity and high cost of in vitro vaccine production. However, their clinical application is hindered by insufficient efficiency in inducing immunogenic cancer cell death (ICD) and systemic inflammation caused by immune adjuvants. Here, personalized cancer vaccines are constructed in situ for melanoma immunotherapy based on bioorthogonal catalytic microneedles, which enable the catalytic release of prodrugs at tumor sites and mediate strong ICD and an enhanced tumor immune response while avoiding systemic immune storms and toxic side effects. By incorporating TiO2 nanosheets supported Pd into swellable microneedles, the bioorthogonal microneedles are constructed to catalyze the depropargylation reaction of doxorubicin (DOX) prodrug and imiquimod (IMQ) prodrug in situ. The activated DOX at subcutaneous tumor sites induced strong ICD and released tumor-associated antigens. Concurrently, the activated IMQ acts as a Toll-like receptor (TLR7) agonist, enhancing the anti-tumor immune response. In vivo experiments demonstrate that this immunotherapy achieves ≈97% inhibition of primary tumors and effectively inhibits untreated distant tumors (≈94% inhibition) and lung metastasis (≈92% inhibition).

Melanoma skin cancer statistics derived from 7442 Japanese patients: Japanese melanoma study

BACKGROUND

Malignant melanoma (MM) is a rare but aggressive cutaneous cancer, accounting for only 2% of skin cancers in Japan but nearly half of skin cancer-related deaths. While the global incidence of MM is rising, its epidemiology varies significantly by ethnicity and geographic region. In Japan, melanoma incidence remains lower than in Western countries, with acral lentiginous melanoma (ALM) being the most prevalent subtype. However, comprehensive epidemiological and clinical data remain limited.

METHODS

We analyzed data from 7442 Japanese melanoma patients collected between 2005 and 2022 through the Japanese Melanoma Study (JMS). Demographic, clinical, and survival data were evaluated, including subtype distribution, TNM staging, and treatment outcomes.

RESULTS

ALM was the most common subtype (40.8%), followed by superficial spreading melanoma (20.2%). Lymph node metastasis was observed in 28.6% of cases, and distant metastasis in 10.9%. The BRAF mutation rate was 27.2%, with significantly lower frequencies in ALM (8.5%) and mucosal melanoma (4.8%). Among Stage IV patients, those treated with both immune checkpoint inhibitors (ICIs) and BRAF(+ MEK) inhibitors demonstrated significantly improved survival compared to chemotherapy alone (P < 0.05). Adjuvant BRAF(+ MEK) inhibitor therapy also resulted in superior relapse-free survival compared to those who did not receive adjuvant therapy (P < 0.005).

CONCLUSION

This study provides the largest dataset of Japanese melanoma patients to date, highlighting distinct epidemiological and clinical characteristics. Given their lower BRAF mutation rates and the limited efficacy of current ICI treatments, these findings emphasize the urgent need for optimize immunotherapy strategies in Japanese melanoma patients.

Prognostic Value of Nevus-Associated Melanoma in Patients with Melanoma

BACKGROUND

Although most melanomas develop de novo, about 30% are nevus-associated melanomas, where the prognostic value is unclear. Our study aimed to determine whether nevus-associated melanoma is associated with sentinel lymph node (SLN) status and prognosis in patients with melanoma.

METHODS

The Sentinel Lymph Node Working Group database, which includes comprehensive clinicopathological and outcome data, was utilized to investigate the association of nevus-associated melanoma with SLN status as well as relapse-free (RFS), melanoma-specific (MSS), and overall survival (OS) using multivariable logistic regression and Cox regression modeling.

RESULTS

A total of 3447 adult patients with a median follow-up of 2.6 years (interquartile range 0.9-6.9) were evaluable. Compared with de novo melanomas, nevus-associated melanomas showed a significant correlation with younger age as well as favorable histological features. The presence of a nevus-associated melanoma was not identified as an independent factor for SLN status (odds ratio 1.06, 95% confidence interval [CI] 0.80-1.41; p = 0.68). Compared with de novo melanomas, nevus-associated melanomas provided independent prognostic information for a favorable RFS (hazard ratio [HR] 0.67, 95% CI 0.53-0.84; p < 0.001), MSS (HR 0.54, 95% CI 0.34-0.85; p = 0.008), and OS (HR 0.42, 95% CI 0.30-0.57; p < 0.001).

CONCLUSION

Melanomas associated with pre-existing nevi appear to be an independent favorable prognostic factor for recurrence and survival and may potentially be used as a clinical parameter for identifying patients with lower risk of recurrence.

Adverse effects of systemic advanced melanoma therapies-do BRAF/MEK inhibitors increase the incidence of mesenteric panniculitis?

OBJECTIVES

BRAF/MEK inhibitors (BRAFi/MEKi) and PD-1 and CTLA-4 immune checkpoint inhibitors (ICI) have revolutionized malignant melanoma treatment and improved patients' clinical outcome significantly. However, these therapies are associated with substance class-specific side effects. Here, selected cases indicate a correlation between the incidence of mesenteric panniculitis (MP) and BRAFi/MEKi treatment. As MP can mimic or conceal underlying malignancy, the aim of the present study was to confirm a potential correlation with BRAFi/MEKi or ICI in a retrospective, observational analysis of melanoma patients.

MATERIALS AND METHODS

In a monocentric retrospective study, abdominal CTs of 490 melanoma patients receiving first-line treatment with ICI (nivolumab, ipilimumab, pembrolizumab, nivolumab/ipilimumab) or BRAFi/MEKi (dabrafenib/trametinib, vemurafenib/cobimetinib, encorafenib/binimetinib) in the adjuvant or advanced situation were evaluated for MP development comparing baseline imaging prior therapy start and follow-up imaging under therapy. MP was defined as an unilocular mesenteric mass characterized by small tissue nodules with increased density of the adjacent fat and a surrounding pseudo-capsule.

RESULTS

384 melanoma patients with ICI (161 women, median age at therapy start: 62 years, IQR: 21 years) and 106 patients with BRAFi/MEKi first-line therapy (46 women, median age: 58 years, IQR: 18 years) were evaluated. MP incidence was significantly higher following BRAFi/MEKi treatment compared to ICI (7.5% vs. 2.9%, p = 0.04). No significance was detected comparing time until MP development from therapy start (174 days, IQR: 518 days [BRAFi/MEKi] vs. 207 days, IQR: 298 days [ICI], p > 0.05).

CONCLUSION

Our study demonstrates a significant increase in MP development following BRAFi/MEKi treatment compared to ICI in patients with melanoma. As this benign condition can mimic or even conceal malignancy, awareness of its appearance is important.

KEY POINTS

Question BRAF/MEK and immune checkpoint inhibitors have revolutionized melanoma treatment but are associated with various side effects, yet data regarding the development of mesenteric panniculitis are scarce. Findings BRAF/MEK inhibitor treatment is associated with a significantly higher rate of mesenteric panniculitis compared to immune checkpoint inhibitor treatment in advanced melanoma. Clinical relevance BRAF/MEK inhibitor-treated patients are at risk for development of mesenteric panniculitis. As this benign finding can mimic or conceal malignancy, awareness of it is important especially in these patients.

Optical super-high magnification dermoscopy of benign and malignant melanocytic lesions in correlation with histopathology

BACKGROUND AND OBJECTIVES

Technical advances have allowed for significant improvements in imaging techniques in recent years. Specifically, lesions can now be depicted at a much higher magnification - up to 400 x - using optical super-high magnification dermoscopy (OSHMD).

PATIENTS AND METHODS

This is a retrospective, observational study assessing 99 melanocytic lesions in patients from the University Hospital Heidelberg. Dermoscopy (20 x) and OSHMD images (90 x, 120 x, 150 x, 180 x and 270 x) were acquired. OSHMD images were assessed for the presence/absence of pigment network, distribution, size and color of cells, dots and roundish nests (small/large), structureless areas and vessels in nevi versus melanomas. Correlation studies with histopathology were performed.

RESULTS

We found that in OSHMD atypical pigment network, irregular dark dots, atypical vessels and irregular grey out-of-focus cells are clues to melanoma. Black dots and small roundish nests in OSHMD images corresponded to nests of atypical melanocytes in melanomas in histopathology. Grey out-of-focus cells in OSHMD images corresponded to melanophages in histopathology and in irregular distribution were found more frequently in melanomas.

CONCLUSIONS

We conclude that knowing about histopathological correlates OSHMD may support differentiating nevi from melanomas.

Light/Ultrasound Dual Responsive Carbon Dots-Based Nanovaccines for Multimodal Activation Tumor Immunotherapy of Melanoma

Melanoma is a highly aggressive and metastatic tumor, and immunotherapy has become the current solution. However, conventional nanovaccines do not strongly activate T cell immune responses. Therefore, development of effective therapeutic nanovaccines to activate systemic antitumor immunity is urgently required. Herein, light/ultrasound (US) dual-responsive carbon dot-based nanovaccines (Cu-N-CDs@OVA) are designed using copper-nitrogen-coordinated carbon dots composited with ovalbumin. Under 650-nm laser irradiation, Cu-N-CDs@OVA exhibited superior photothermal ablation of primary tumors, induced immunogenic cell death and released antigens by phototherapy, facilitating the maturation of dendritic cells (DCs). More importantly, Cu-N-CDs@OVA stably penetrated and diffused upon US treatment, eradicating metastatic tumors and generating low-dose reactive oxygen species to activate DCs. By integrating with the model antigen OVA, the combined multimodal treatment promotes DC maturation to activate systematic antitumor immunity. This is the first example of a light/US dual-responsive therapeutic nanovaccine that provides a paradigm for the production of personalized nanovaccines against malignant tumors.

Analysis and comparison of the trends in burden of malignant cutaneous melanoma in East Asian countries and regions and worldwide from 1991 to 2021

Objectives

This study aims to comprehensively analyze temporal trends in the burden of malignant melanoma (MM) in East Asia, focusing on incidence, prevalence, mortality, and disability-adjusted life years (DALYs) from 1991 to 2021. It further seeks to compare these trends with the global burden of disease.

Study design

The study utilized data from the Global Burden of Disease (GBD) database to examine the disease burden of MM across East Asian countries and regions, as well as globally, over a 30-year period (1991-2021).

Methods

We assessed changes in the incidence, prevalence, mortality, and DALYs associated with MM in East Asia and globally using GBD database open-source data. To capture the underlying trends in the disease burden, we applied the Joinpoint regression model to calculate the average annual percentage change (AAPC) and corresponding 95% confidence intervals (95% CI). A detailed comparative analysis was conducted to explore differences in the burden of MM across East Asian regions and compared with global trends, with particular emphasis on age, sex, and temporal changes.

Results

The greatest increase in MM incidence in East Asia was observed in Korea, where the age-standardized incidence rate (ASIR) rose from 0.603 cases per 100,000 population (95% CI: 0.389-0.789) in 1991 to 1.896 cases per 100,000 (95% CI: 0.78-2.499) in 2021. Regarding prevalence, China exhibited the most significant increase in East Asia, with the age-standardized prevalence rate (ASPR) increasing from 0.699 (95% CI: 0.451-0.864) per 100,000 in 1991 to 4.157 (95% CI: 2.195-5.633) per 100,000 in 2021. The highest increases in MM mortality and DALYs were noted in Taiwan Province of China, where the age-standardized mortality rate (ASMR) increased from 0.36 (95% CI: 0.339-0.382) per 100,000 in 1991 to 0.414 (95% CI: 0.414) per 100,000 in 2021. Similarly, the age-standardized DALY rate (ASDR) in Taiwan rose from 10.375 (95% CI: 9.781-11.049) per 100,000 in 1991 to 11.647 (95% CI: 10.558-12.478) per 100,000 in 2021. Age and gender exhibited distinct patterns of influence on the MM burden: while ASIR generally increased with age, ASPR initially increased and later plateaued. Both ASMR and ASDR demonstrated a positive correlation with age. Additionally, male populations consistently exhibited higher morbidity and mortality rates than females.

Conclusion

Over the period from 1991 to 2021, there were significant variations in the incidence, prevalence, mortality, and DALY rates of MM across East Asian countries and regions, including China, Japan, South Korea, North Korea, and Taiwan. These disparities underscore the need for region-specific, proactive prevention strategies and targeted public health interventions to mitigate the growing burden of malignant melanoma in the region.

Natural Killer Cell Activation Signature Identifies Cyclin B1/CDK1 as a Druggable Target to Overcome Natural Killer Cell Dysfunction and Tumor Invasiveness in Melanoma

Background/Objectives: Natural killer (NK) cells play a crucial role in immune surveillance against melanoma, yet they frequently exhibit dysfunction in the tumor microenvironment. This study aims to establish an NK cell activation-related prognostic signature and identify potential druggable targets to overcome NK cell dysfunction. Methods: A prognostic signature was developed using the TCGA-SKCM cohort and validated across independent datasets. NK cell activation and cytotoxicity were evaluated in melanoma-NK-92MI co-culture systems via flow cytometry. Mechanistic studies employed Western blotting, co-immunoprecipitation, ELISA, and qRT-PCR. Single-cell RNA-seq data were used to analyze cell-cell communication. Results: A four-gene NK cell activation signature was identified and validated for prognostic significance across five independent melanoma datasets. Among the identified genes, cyclin B1 (CCNB1) emerged as a novel therapeutic target for overcoming NK cell resistance. In vivo, pharmacological inhibition of the CCNB1/Cyclin-dependent kinase 1 (CDK1) complex with RO-3306 significantly suppressed melanoma growth by enhancing NK cell infiltration and IFN-γ production. In vitro, CCNB1 knockdown in melanoma cells augmented NK-92MI activation, as evidenced by increased expression of CD69, CD107a, IFN-γ, and NKG2D, thereby improving NK cell-mediated cytotoxicity. Mechanistically, in melanoma cells, the CCNB1/CDK1 complex phosphorylates STAT3, activating the IL-6/STAT3 positive feedback loop, which upregulates PD-L1 and enables resistance to NK cell-mediated cytotoxicity. Beyond its role in immune evasion, CCNB1 also promoted melanoma invasiveness by inducing epithelial-mesenchymal transition (EMT) through the TGF-β-SMAD2/3 signaling. Conclusions: This study establishes CCNB1/CDK1 as a novel immunotherapeutic target and uncovers a new role for CDK1 inhibitors in enhancing NK cell function and suppressing melanoma progression.

Immunotherapy in Advanced Cutaneous Melanoma: From the Optimal Treatment Duration to the Impact on Survival in Case of Early Discontinuation Due to Immune-Related Adverse Events

Immune checkpoint inhibitors (ICIs) have improved the prognosis of patients with cutaneous melanoma. Immunotherapy (IT) is generally well tolerated, but an increasing area of investigation concerns the optimal treatment duration of anti-programmed cell death-1 (anti-PD1) regimens to limit the immune-related adverse events in patients who obtained a clinical response. Another point of interest is the impact of the early discontinuation of ICIs on the maintenance of response in terms of survival in patients developing grade 3-4 adverse events that mostly occur in those receiving the combo-IT. Currently, we are still far from having final conclusions on these topics and, thus, the present review aims to describe the recent data about the optimal treatment duration and the maintenance of response in the case of early discontinuation. In this context, we include data on the real life of patients from our Medical Oncology Center who discontinued anti-PD1 after at least a stable disease or those interrupting the combo-IT due to adverse events.

High expression of SOX10 is correlated with poor prognosis and immune infiltrates in skin cutaneous melanoma

Background

Skin Cutaneous Melanoma (SKCM) is a malignant tumor and the prediction of its prognosis remains challenging. Sex determining region Y-box 10 (SOX10) is over-expressed in SKCM and reported to accelerate tumor invasion and immunosuppression. Although studies have suggested the correlation of immune infiltration between SOX10 and SKCM, further in-depth explore of the immunomodulatory role of SOX10 is still needed. Therefore, we assessed the prognostic role of SOX10 and its correlation with immune infiltration and checkpoint expression.

Methods

RNA sequencing data were obtained for analysis of SOX10 expression and differentially expressed genes (DEGs) from the Cancer Genome Atlas (TCGA). Moreover, functional enrichment analysis of SOX10-related DEGs was performed by GO/KEGG, GSEA. Receiver operating characteristic (ROC) curves were used to assess the diagnostic value of SOX10 in SKCM. Kaplan-Meier method was conducted to assess the effect of SOX10 on survival. Additionally, the clinical significance of SOX10 in SKCM was figured out by LASSO and prognostic nomogram model. We analyzed SOX10-related immune cell infiltration and expression of immune checkpoints. Finally, validations were performed through immunohistochemical analysis.

Results

SOX10 was low expressed in a range of malignant tumor tissues except SKCM. Totally, 1029 differentially significant genes (DSGs) were identified between SOX10 low- and high- expression group, of which 50 genes were upregulated and 979 genes were downregulated. Additionally, SOX10 high expression was remarkably associated with pathologic stage, age and breslow depth in a sample of 472 cases (P < 0.05). Screening was performed by LASSO coefficients to select non-zero variables that satisfied the coefficients of lambda, and 8 genes were screened out. The forest plot results showed that only OCA2 and TRAT1 had statistical significance (P < 0.05) by multi-factor COX regression analysis. SOX10, OCA2, TRAT1, pathologic stage, age and breslow depth were included in the nomogram prognostic model. Furthermore, upregulation of SOX10 expression inhibited immune infiltration in SKCM.

Conclusion

Overall, high expression of SOX10 was correlated with poor prognosis in SKCM, which may be related to suppression of immune infiltration. The DSGs and pathways identified in our research have initially provided an insight into the molecular mechanisms underlying the progression of SKCM.

Long non-coding RNA CYTOR promotes the progression of melanoma via the miR-485-5p/GPI axis

Background

Recent research has underscored the critical role of long non-coding RNAs (lncRNAs) in tumorigenesis and malignancy development. Nevertheless, the role of lncRNA cytoskeleton regulator RNA (CYTOR) in the progression of melanoma remains only partially elucidated. This research seeks to explore the impact of CYTOR on melanoma development and to elucidate the molecular mechanisms involved.

Methods

In vitro and in vivo models were used to assess CYTOR expression levels by QPCR and Western blotting. Melanoma cell proliferation, migration, and invasion were assessed by CCK-8 assay, scratch wound assay and transwell invasion experiments. The mechanism of CYTOR promoting melanoma progression was verified in a xenograft tumor mouse model.

Results

Our investigation identified a marked increase in CYTOR expression levels in both melanoma tissues and cells. Experiments conducted both in vitro and in vivo revealed that CYTOR markedly stimulated melanoma cell proliferation, migration, and invasion. Dual-luciferase reporter assays confirmed the direct binding of miR-485-5p to CYTOR, and glucose-6-phosphate isomerase (GPI) was identified as a direct target of miR-485-5p.

Development of 99mTc-labeled melanin-targeted probes for SPECT imaging of melanoma

PURPOSE

Melanoma is a highly aggressive skin cancer with poor prognosis, highlighting the need for early detection. This study aims to develop a 99mTc-labeled single photon emission computed tomography (SPECT) probe targeting melanin to improve melanoma detection with enhanced specificity and cost-effectiveness.

METHODS

Six potential 99mTc-labeled probes were synthesized by conjugating small molecules with nitrogen-rich fatty chains or cyclic structures to 99mTc. These 99mTc-complexes were then assessed in vitro for their lipid-water partition coefficient, radiochemical stability, and cellular uptake. In vivo studies included biodistribution, SPECT/CT imaging, pharmacokinetics, stability and biocompatibility studies were conducted in various mouse models.

RESULTS

These six probes exhibited high radiolabeling yields (> 95%) and radiochemical purities (> 95%). In vitro cell uptake and blocking experiments demonstrated their binding capability and specificity for melanin. Among these probes, 99mTc-SMIC-4006 displayed the highest tumor uptake (5.18 ± 1.55%ID/g at 1 h) and significantly higher uptake in B16F10 xenografts compared to non-melanotic A375 xenografts (p < 0.01). The initial tumor-to-blood ratio for 99mTc-SMIC-4006 was 4.30 ± 0.63 at 1 h, increasing to 10.27 ± 5.13 at 6 h. Importantly, SPECT/CT imaging of 99mTc-SMIC-4006 clearly delineated B16F10 tumor regions with high contrast, while A375 xenografts showed minimal uptake.

CONCLUSION

99mTc-SMIC-4006 is a promising SPECT probe for melanoma imaging, offering high tumor specificity, excellent uptake, and ideal tumor-to-background contrast, with strong potential for clinical application.

Exploring the association between dietary inflammatory index (DII) and different types of skin cancer: a cross-sectional study from NHANES 1999-2018

BACKGROUND

The potential role of diet-related inflammatory responses in skin carcinogenesis is gaining increasing recognition. This study investigated the association between the Dietary Inflammatory Index (DII) and different types of skin cancer in the United States general population.

METHODS

The study analyzed cross-sectional data on 45,409 participants in the 1999-2018 National Health and Nutrition Examination Survey (NHANES). The association between the DII and different types of skin cancer was estimated using weighted multivariable logistic regression, and its non-linearity was examined using restricted cubic spline (RCS) regression. Subgroup analyses were stratified by age, sex, race, body mass index, hypertension status, diabetes status, and frequency of skin-protecting behaviors.

RESULTS

The adjusted odds ratios (ORs) with 95% confidence intervals (CIs) for melanoma were 1.54 (1.02-2.35), 1.67 (1.02-2.73), and 1.55 (0.86-2.80) for the second, third, and fourth DII quartiles, respectively, compared with the first quartile. The adjusted ORs with 95% CIs for non-melanoma skin cancer (NMSC) were 0.90 (0.68-1.19), 0.96 (0.69-1.35), and 1.01 (0.70-1.45) for the second, third, and fourth DII quartiles, respectively, compared with the first quartile. The RCS curves showed no overall or non-linear significant association between DII and melanoma prevalence (P = 0.240, Pnon-linearity = 0.144) or NMSC (P = 0.068, Pnon-linearity = 0.410).

CONCLUSION

This study suggests that Compared with participants in DII quartile 1, those in DII quartiles 2 and 3 had a significantly increased risk of melanoma, whereas those in quartile 4 did not. These findings underscore the potential role of dietary inflammation in melanoma etiology and highlight the importance of further research to better understand and mitigate this risk factor.

Current Treatment Paradigms for Advanced Melanoma with Brain Metastases

The therapeutic management of melanoma brain metastases has undergone a profound revolution during recent decades. Optimal integration of systemic therapies with local treatments seems to represent the strategy to pursue in order to maximize clinical outcomes, stressing the need for real multidisciplinary care in this setting of patients. However, the current approach in the clinics does not necessarily reflect what the current guidelines state, and several pending issues are present, from the ideal therapeutic sequence between stereotactic radiosurgery (SRS) and drug administration to the current role of surgery and whole brain radiotherapy (WBRT), all of which need to be addressed. This narrative review aims to provide practical help for navigating the current controversies, with an eye towards possible future advancements in the field, which could help to obtain a comprehensive molecular characterization of the tumor and a more personalized patient-centered therapeutic approach.

Linking Parkinson's disease and melanoma: the impact of copper-driven cuproptosis and related mechanisms

Patients with Parkinson's disease (PD) exhibit an increased risk of melanoma, implying shared yet incompletely understood molecular mechanisms. This study aimed to delineate these common and distinct pathways by analyzing gene expression profiles from the Gene Expression Omnibus. A total of 90 differentially expressed genes (DEGs) were commonly regulated, while 173 DEGs exhibited divergent regulation between PD and melanoma. Protein-protein interaction analysis identified SNCA as a central node within a 21-protein network. LASSO regression revealed 13 hub genes (e.g., CCNB1, CCNH, CORO1C, and GSN) with high diagnostic accuracy (AUC >0.93) across both conditions. Gene set enrichment analysis implicated copper-induced cell death (cuproptosis) in PD neurons and melanoma cells, linking this process to hub genes. RT-qPCR confirmed increased SNCA expression during cuproptosis. Additional analyses identified macrophage involvement and WNT-β-catenin signaling as relevant. These findings suggest cuproptosis as a potential therapeutic target in PD and melanoma.

CDC25A inhibition sensitizes melanoma cells to doxorubicin and NK cell therapy

Cell division cycle 25 (CDC25) phosphatases serve as crucial regulators of cell cycle phase transitions and essential components of the checkpoint machinery involved in DNA damage response. Emerging evidence indicates the oncogenic potential of CDC25 family members across various cancers. However, comprehensive insights into the expression pattern and function of the CDC25 family in diverse cancers remain unexplored. In our study, we investigated CDC25 family using multiple databases, including gene expression levels, molecular signatures, diagnosis value, and prognostic value in pan-cancer. Furthermore, we focused on melanoma and systematically explored CDC25A expression and its clinical correlations. As a result, the expression of CDC25 family members is significantly abnormal in most cancers, correlating with poorer prognosis. CDC25 family members are differently regulated by DNA methylation and genetic alterations across various cancers. In addition, CDC25 family plays a critical role in the malignant progression of melanoma. Functional investigation reveals that CDC25A inhibition suppresses the proliferation of melanoma cells and sensitizes melanoma cells to chemotherapy and NK cell therapy. In conclusion, our study suggests that CDC25 family may serve as a significant biomarker for diagnosis and prognosis across multiple cancers, with CDC25A as a promising therapeutic target for melanoma.

Novel Biological Strategies for Melanoma Therapy: A Focus on lncRNAs and Their Targeting

Increasing evidence revealed that restoring the correct expression of lncRNAs could have implications in the management of melanoma patients. In this context, here, we aim to dissect the main characteristics of lncRNAs altered in melanoma and their crosstalk with the signaling pathways involved in the progression of this disease. We also highlight the role of nucleic acid-based techniques and natural compounds (i.e., phytochemicals) as a therapeutic tool to increase or silence their expression in cancer cells. Finally, we explore the advances in nanotechnologies as delivery systems to efficiently carry these chemicals into cancer cells, thus limiting their potential off-target effects. The analysis of the literature showed that HOTAIR, MALAT1, and H19 are the oncogenic lncRNAs most studied in melanoma, while MEG3 is an important tumor suppressor decreased in this cancer. The aberrant expression of these lncRNAs affects several hallmarks of cancer, e.g., proliferation, motility, and epithelial to mesenchymal transition, promoting the melanoma plasticity and drug resistance. In this frame, siRNA, antisense oligonucleotide, and CRISPR-Cas9 genome editing appear to be the most effective nucleic acid strategies to restore the physiologic expression of lncRNA, while curcumin, resveratrol, and quercetin are the main phytochemicals able to target and influence the expression of lncRNAs altered in cancer. Overall, this study provides a comprehensive overview regarding the role of lncRNAs in the phenotype plasticity of melanoma cells and their potential targeting using RNA-based therapy and natural products.

The Assessment of the Effect of Autophagy Inhibitors-Chloroquine and 3-Methyladenine on the Antitumor Activity of Trametinib Against Amelanotic Melanoma Cells

Malignant melanoma, particularly amelanotic melanoma, contributes to a very serious problem in public health. One way to find new therapies is to learn about and understand the molecular pathways that regulate cancer growth and development. In the case of a tumor, the autophagy process can lead to the development or inhibition of cancer. This study aimed to assess the cytotoxicity of connection trametinib (MEK1 and MEK2 kinase inhibitor) with autophagy inhibitors-chloroquine (lysosomal clearance of autophagosomes inhibitor) and 3-methyladenine (phosphatidylinositol 3-kinases inhibitor), on two amelanotic melanoma cell lines (C32 and A-375). The results showed that combination therapy had better anti-proliferative effects than alone therapy in both cell lines. The C32 cell line was more sensitive to 3-methyladenine treatment (alone and in combinations), and the A375 line showed sensitivity to chloroquine and 3-methyladenine (alone and in combinations). The anti-proliferative effect was accompanied by dysregulation of the cell cycle, a decrease in the reduced thiols, the depolarization of the mitochondrial membrane and the level of p44/p42 MAPK. Both inhibitors have the ability to induce apoptosis. Differences in the level of LC3A/B and LC3B proteins between the chloroquine and the 3-methyladenine samples indicate that these drugs inhibit autophagy at different stages. The enhancement of the effect of trametinib by autophagy inhibitors suggests the possibility of combining drugs with anti-cancer potential with modulators of the autophagy process.

A Phase I study targeting the APE1/Ref-1 redox signaling protein with APX3330: First clinical agent targeting APE1/Ref-1 in Cancer

Purpose

APX3330 is an oral agent targeting the redox signaling activity of Ape1/Ref-1 (Ref-1), a key regulator of transcription factors involved in inflammation and tumorigenesis. APX3330 selectively inhibits Ref-1's redox function without affecting its DNA repair role. This Phase 1, multicenter, open-label, dose-escalation study in advanced solid tumor was aimed at determining the recommended Phase 2 dose (RP2D) while assessing safety, pharmacokinetics, and biomarker evidence of target engagement. Clinical trial: NCT03375086 .

Patients and Methods

Nineteen cancer patients were treated, with eight completing follow-up. Subjects received APX3330 orally twice daily in 21-day cycles, starting at 240 mg/day and escalating in 120 mg/day increments. Adverse event (AE) monitoring followed a 1 pt/cohort approach until a >G2 toxicity event, after which a 3+3 design was implemented. Treatment continued until disease progression, consent withdrawal, or intolerable toxicity. Antitumor activity was assessed using RECIST 1.1, and pharmacodynamic markers included serum Ref-1 levels and circulating tumor cells.

Results

Six subjects had stable disease for >4 cycles, with four remaining on study for 252- 421 days. No treatment-related serious adverse events occurred. One subject (720 mg cohort) withdrew due to Grade 3 maculopapular rash (dose-limiting toxicity). Laboratory assessments and ECGs showed no clinically significant abnormalities.

Conclusions

APX3330 demonstrated clinical benefit by stabilizing disease in ∼33% of subjects. Ref-1 target engagement was confirmed via biomarker analyses, with reduced serum Ref-1 and circulating tumor cells. The RP2D is 600 mg daily, with APX3330 showing a favorable safety profile and target-mediated effects.

A Microneedle Patch Delivers Mitochondria- and Lysosomes- Dual Targeting Prodrug-Like Photosensitizers with Regulated Photoactivity for Precise Photodynamic Therapy

Antitumor photodynamic therapy (PDT) faces huge challenges as selectivity and phototoxic damage, requiring delivery photosensitizers (PSs) to specifically accumulate in tumors even in organelle, and avoid the phototoxic damage during delivery. Herein, a microneedle patch (AIE-mito-TPP@MN) containing mitochondria- and lysosomes- dual targeting prodrug-like PSs (AIE-mito-TPP/AlPcSNa4) that is self-assembled by mitochondria-targeted aggregation-induced-emission molecule (AIE-mito-TPP) and lysosome-targeted aluminum phthalocyanine tetrasulfonate (AlPcSNa4), is developed to achieve cancer-cell-organelle-specific targeting delivery for precise PDT with high selectivity and low phototoxic damage. AIE-mito-TPP/AlPcSNa4 displays prodrug-like activity via the regulated photoactivity to reduce the phototoxic damage caused by the "always on" PSs. Meanwhile, AIE-mito-TPP/AlPcSNa4@MN can insert into the epidermis to achieve rapid AIE-mito-TPP/AlPcSNa4 delivery in tumor lesion, and enhance selective accumulation in tumor cells. The higher lysosomal acidity in tumor cells facilitates AIE-mito-TPP/AlPcSNa4 disassembly and promotes targeting. Under light irradiation, AIE-mito-TPP/AlPcSNa4@MN impairs mitochondrial and lysosomal function to induce deeper tumor cells apoptosis at a low dose (≈6 µg), presenting greater therapeutic efficacy than AIE-mito-TPP@MN, AlPcSNa4@MN, or intravenous injection. Moreover, AIE-mito-TPP/AlPcSNa4@MN presents good biocompatibility as lower accumulation and targeting in normal cells, as well as the regulated photoactivity of prodrug-like PSs. Therefore, the dual organelle-targeting microneedle possesses great potential for precise PDT with high selectivity.

Tumor‑associated neutrophils: Critical regulators in cancer progression and therapeutic resistance (Review)

Cancer is the second leading cause of death among humans worldwide. Despite remarkable improvements in cancer therapies, drug resistance remains a significant challenge. The tumor microenvironment (TME) is intimately associated with therapeutic resistance. Tumor‑associated neutrophils (TANs) are a crucial component of the TME, which, along with other immune cells, play a role in tumorigenesis, development and metastasis. In the current review, the roles of TANs in the TME, as well as the mechanisms of neutrophil‑mediated resistance to cancer therapy, including immunotherapy, chemotherapy, radiotherapy and targeted therapy, were summarized. Furthermore, strategies for neutrophil therapy were discussed and TANs were explored as potential targets for cancer treatment. In conclusion, the need to explore the precise roles, recruitment pathways and mechanisms of action of TANs was highlighted for the purpose of developing therapies that precisely target TANs and reverse drug resistance.

The Prognostic Significance of Tumor Budding and Tumor-Infiltrating Lymphocytes in Patients Diagnosed With Malignant Melanoma

ABSTRACT

The tumor microenvironment plays a critical role in malignant melanoma, influencing progression and patient outcomes, particularly through tumor budding (TB) and tumor-infiltrating lymphocytes (TILs). Despite the importance of TB, its detailed impact still needs to be explored, especially its interaction with TILs. This study evaluates the prognostic significance of TB and TILs in malignant melanoma, assessing their potential as indicators for disease progression and survival. Conducted at Akdeniz University, the research included 92 patients diagnosed between 2014 and 2021. TB was evaluated according to the International Tumor Budding Consensus Conference guidelines, and TILs were assessed by the International Immuno-Oncology Biomarker Working Group standards. The analysis revealed significant correlations between TB and the level of anatomic invasion, Breslow thickness, satellite nodules, lymph node metastasis, distant metastasis, and stage ( P < 0.05). A notable inverse relationship between TB and intratumoral TILs suggested their different roles in tumor progression. Tumor subtype, level of anatomic invasion, satellite nodules, lymphovascular invasion, lymph node metastasis, distant metastasis, stage, TILs, and TB were significant risk factors associated with poor prognosis ( P < 0.005). Multivariate Cox regression identified histologic subtype and TB >10 as independent prognostic factors, underscoring the need for further research to integrate TB and TILs into clinical practice for better patient management and treatment planning.

Genomic profiles of patients with skin melanoma in the era of immune checkpoint inhibitors

The use of immune checkpoint inhibitors (ICIs) for treating melanoma has dramatically improved patient prognosis. The genomic profiles of patients receiving ICI therapy would provide valuable information for disease management and treatment. We investigated the genomic profiles of patients with melanoma who had received ICI therapy and explored associations with clinical features and outcomes via a large-scale nationwide database in Japan (the C-CAT database). We identified 339 patients eligible for this study. The most frequent genetic mutations were found in the BRAF (27%), TERT (24%), and NRAS (19%) genes, and the most common copy number variations (CNVs) were in the CDKN2A (36%), CDKN2B (26%), and MTAP (19%) genes. Associations with high tumor mutational burden (TMB-high) status were significant for TERT (p < 0.001), NF1 (p < 0.001), ROS1 (p = 0.015), POLE (p = 0.045), and POLD1 (p = 0.008) mutations, along with older age (≥65 years, p = 0.036). Patients with multiple metastases (two or more) were more likely to have NOTCH3 mutations (p = 0.017) and be younger than 65 years (p = 0.024). In particular, as well as younger age, patients with brain metastases were more likely to harbor BRAF mutations (p < 0.001), while those with liver metastases were more likely to harbor NOTCH3 mutations (p < 0.001) but not CDKN2B CNVs (p = 0.041). Patients with NRAS mutations were less likely to respond to ICI therapy (p = 0.014) and exhibited shorter overall survival (p = 0.006). In this population, the frequency of BRAF mutations was lower than that in fair-skinned populations, but the associations between genomic profiles, clinical features, and outcomes were similar to those previously reported in fair-skinned populations.

Study on the activity of targeted delivery of DOX against melanoma by exosome-like nanovesicles of Rhodiola rosea

Melanoma is the main cause of death from skin cancer. The current treatment methods have prominent toxic side effects. In order to more effectively inhibit melanoma and reduce the toxic side effects during treatment, this paper constructs an engineering system using DSPE-PEG2000-pYEEIE(pYEEIE) molecules to modify exosome-like nanovesicles vesicles of Rhodiola rosea (RELNs) and load Doxorubicin (DOX). As a drug system, the aim is to achieve better targeting activity of the system towards melanoma cell A375. The results showed that the morphology and particle size of the prepared RELNs met the defined criteria for evaluating extracellular vesicles. The pYEEIE-RELNs-DOX drug delivery system has a better inhibitory effect on cell proliferation compared to DOX and RELNs-DOX. At the same time, the pYEEIE-RELN-DOX drug delivery system also showed better targeting towards tumor cells. In summary, this study proposes for the first time RELNs as a new generation of drug delivery carriers and uses them for drug delivery and inhibition of melanoma cell toxicity. This lays the foundation for subsequent animal and clinical experiments, and provides new ideas for the treatment of skin cancer caused by melanoma.

Vital Characteristics Cellular Neural Network (VCeNN) for Melanoma Lesion Segmentation: A Biologically Inspired Deep Learning Approach

Cutaneous melanoma is a highly lethal form of cancer. Developing a medical image segmentation model capable of accurately delineating melanoma lesions with high robustness and generalization presents a formidable challenge. This study draws inspiration from cellular functional characteristics and natural selection, proposing a novel medical segmentation model named the vital characteristics cellular neural network. This model incorporates vital characteristics observed in multicellular organisms, including memory, adaptation, apoptosis, and division. Memory module enables the network to rapidly adapt to input data during the early stages of training, accelerating model convergence. Adaptation module allows neurons to select the appropriate activation function based on varying environmental conditions. Apoptosis module reduces the risk of overfitting by pruning neurons with low activation values. Division module enhances the network's learning capacity by duplicating neurons with high activation values. Experimental evaluations demonstrate the efficacy of this model in enhancing the performance of neural networks for medical image segmentation. The proposed method achieves outstanding results across numerous publicly available datasets, indicating its potential to contribute significantly to the field of medical image analysis and facilitating accurate and efficient segmentation of medical imagery. The proposed method achieves outstanding results across numerous publicly available datasets, with an F1 score of 0.901, Intersection over Union of 0.841, and Dice coefficient of 0.913, indicating its potential to contribute significantly to the field of medical image analysis and facilitating accurate and efficient segmentation of medical imagery.

Thiotaurine inhibits melanoma progression by enhancing Ca2+ overload-induced cellular apoptosis

BACKGROUND

Melanoma is the most dangerous type of skin cancer with poor therapy outcomes. Since malignant cells are more susceptible to Ca2+ overload than normal cells, activating Ca2+ overload-mediated apoptosis may be a promising strategy to inhibit melanoma progression. Hydrogen sulfide (H2S) donors can regulate Ca2+ channels, but their effects on melanoma cells remain unclear.

OBJECTIVE

To explore the effects of Thiotaurine (TTAU), an H2S donor, on melanoma cells and its underlying mechanisms.

METHODS

We tested the effect of TTAU by culturing melanoma cells in vitro and establishing the xenograft model of mice in vivo. Cell proliferation and apoptosis were assessed using the CCK-8 test and flow cytometry. Molecules involved in apoptosis or Ca2+-related signal transduction were analyzed by western blotting. Immunofluorescence was used to measure Ca2+ levels, mitochondrial damage, and reactive oxygen species (ROS).

RESULTS

TTAU significantly reduced melanoma cell viability and induced apoptosis both in vitro and in vivo. Mechanistically, TTAU increased intracellular Ca2+, upregulated transient receptor potential vanilloid 1(TRPV1), and decreased activating transcription factor 3(ATF3) by nuclear factor of activated T cell cytoplasmic 1(NFATc1). TTAU also caused mitochondrial damage and ROS overproduction, which also promoted apoptosis.

CONCLUSION

We first elucidate that TTAU inhibits melanoma progression by activating Ca2+ influx-NFATc1-ATF3 signaling and aggravating mitochondrial oxidative stress, in which TRPV1 may act as an amplifier for Ca2+ influx. Our research is expected to provide new ideas for the treatment of tumors such as melanoma, as well as the clinical application of reactive sulfur species-based drugs.

Tri-Phenyl-Phosphonium-Based Nano Vesicles: A New In Vitro Nanomolar-Active Weapon to Eradicate PLX-Resistant Melanoma Cells

Cutaneous metastatic melanoma (CMM) is the most aggressive form of skin cancer, with characteristics including a poor prognosis, chemotherapy-induced secondary tumorigenesis, and the emergence of drug resistance. Our recent study demonstrated that triphenyl phosphonium (TPP)-based nanovesicles (BPPB), which have amphiphilic properties, exert potent ROS-dependent anticancer effect against PLX4032 (PLX)-sensitive MeOV BRAFV600E and MeTRAV BRAFV600D mutant cell lines, evidencing more marked efficacy on MeOV cells. Here, taking advantage of this in vitro model, the antitumoral effect of BPPB was tested on PLX-resistant (PLX-R) MeOV BRAFV600E and MeTRAV BRAFV600D mutant cell lines to find a new potential strategy to fight melanoma therapy resistance. Specifically, we investigated both its effects on cell viability in dose- and time-dependent experiments and those on ROS generation. Our results show that BPPB exerted strong antiproliferative effects, regardless of their acquired resistance of cells to PLX, that correlated with ROS overproduction for 24 h treatments only. Moreover, in terms of cell viability, PLX-R MeTRAV cells demonstrated a remarkably higher tolerance to 24 h BPPB treatment than PLX-R MeOV. On the contrary, BPPB exposure for longer periods induced similar responses in both cell lines (IC50 = 87.8-106.5 nM on MeOV and 81.0-140.6 nM on MeTRAV). Notably, BPPB cytotoxicity on non-tumorigenic human keratinocytes (HaCaT) was low, thus establishing that BPPB is appreciably selective for CMM cells, allowing for selectivity index values (SIs) up to 11.58. Furthermore, the BPPB concentration causing 50% hemolysis (HC50) was found to be 16-173 and 4-192-fold higher than the IC50 calculated for PLX-R MeOV and MeTRAV cells, respectively. Correlation studies established that BPPB exerts cytotoxic effects on PLX-R MeOV and MeTRAV cells by a time-dependent mechanism, while a concentration-dependent mechanism was observed only at 24 h of exposure. Finally, a ROS-dependent mechanism can be assumed only in PLX-R MeTRAV cells in 72 h treatment.