Dr. Rapisuwon on Frontline Immunotherapy Vs Targeted Therapy in Melanoma Subtypes

Suthee Rapisuwon, MD, medical oncologist, MedStar Health, discusses the utility of frontline immunotherapy vs targeted therapy in acral and mucosal melanoma.

Patients with newly diagnosed acral or mucosal melanoma should undergo genetic testing to identify targetable mutations, Rapisuwon says. However, whether a patient should receive up-front targeted therapy or immunotherapy is debatable, explains Rapisuwon.

Typically, patients will receive immunotherapy in the frontline setting because immunotherapy can confer long-term responses for patients, Rapisuwon explains. Additionally, the majority of patients with acral or mucosal melanoma do not harbor actionable alterations, Rapisuwon says. For example, approximately 20% to 30% of patients with mucosal melanoma harbor KIT mutations, Rapisuwon says. Notably, some patients have BRAF-positive mucosal melanoma and are eligible for BRAF or MEK inhibitors, Rapisuwon concludes.