Clinical pathway of melanoma cancer

Melanoma is the most deadly type of skin cancer that originates from the malignant transformation of melanocytes. Epidemiology and Risk Factors The incidence of melanoma skin cancer is increasing annually worldwide at a faster rate than any other type of cancer. Also, unlike other solid tumors, melanoma affects more people. It affects the young and middle-aged. Although melanoma has long been considered a cancerous malignancy with few treatment options, increased biological understanding has significantly improved patient prognosis. In this study, the signaling pathways that regulate the pathogenesis of melanoma, including genetic mutations, have been investigated. Clinically, melanoma cases are classified into ۴ main subgroups according to histopathological features: superficial spreading melanoma, nodular melanoma, malignant lentigo melanoma and acral lens melanoma. NRAS mutations are one of the most common somatic mutations in human melanomas with a frequency of ۱۵-۳۸%. Most NRAS mutations occur at codon ۶۱ in exon ۳, where glutamine is mutated to arginine or lysine. This mutation causes the activation of RAS proteins and consequently the growth of malignant cells through the activation of MAPK and K۳PI pathways. Familial mutations also cause malignant melanoma. These mutations increase the risk of developing malignant melanoma up to ۲ times. TERT mutations have also been found to be a somatic alteration with a high rate in melanoma. Mutations in TERT lead to the binding of ETS transcription factors to the TERT promoter, leading to a fourfold increase in TERT transcriptional activity. The MITF gene results in a change of glutamic acid to lysine, which has a moderate risk. The MAPK pathway is a major regulatory pathway involved in melanoma. This pathway is involved in cell growth, migration, differentiation, proliferation and apoptosis. The MAPK pathway can be initiated by receptor tyrosine kinase binding to integrin adhesion between the cell membrane and the extracellular matrix. Over the years, melanomas tend to run in families, generally with specific patterns of malignancy, such as multiple melanoma syndrome. Understanding the underlying mechanisms of melanoma pathogenesis is essential, which may lead to significant improvements in therapeutic approaches and expand clinical options for melanoma treatment. Melanoma treatment approaches have undergone a significant evolution in the last few decades due to advances in the understanding of melanoma pathogenesis and, as a result, revolutionary advances in targeted therapies that specifically intervene in mutated driver genes.

کلیدواژه ها:

Melanoma ، Somatic mutation ، Treatment ، clinical pathway