Resumen
Melanoma is the most lethal form of skin cancer and has seen a rising incidence globally over the last 10 years. A majority of melanomas arise from the skin as a result of exposure to ultraviolet radiation. However, even within this group of ?cutaneous melanomas?, there is considerable clinical and molecular heterogeneity. In this study, we sought to understand how different genetic ?drivers? in a group of 254 patients with cutaneous melanomas influenced overall survival and response to immunotherapy. We found that NRAS mutation correlated with decreased survival and that tumor mutational burden (an estimate of the amount of genetic change within each tumor) correlated with improved responses to immune checkpoint inhibition. We also found that almost all cutaneous melanomas have a driver mutation in the MAPK pathway, underscoring the key role of MAPK-targeted therapies in melanoma drug development.