作者: David M. Miller , Keith T. Flaherty , Hensin Tsao
DOI: 10.1016/J.JAAD.2014.01.866
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摘要: Insights into the underlying genetic and biologic drivers of melanoma their clinical consequences have developed at a vertiginous pace in last decade. Several key determinants tumor development progression emerged, including dysregulations p16:cyclin D-CDK4/6:RB pathway, alterations telomerase promoter, perturbations mitogenactivated protein kinase (MAPK) pathway. An appreciation complex interplay between immune system microenvironment importance molecules that govern checkpoint, such as cytotoxic T-lymphocyte antigen 4 programmed death 1/programmed ligand 1, has also developed. While this is undoubtedly an exciting time field, these important advances bring with them new challenges for clinician. Patients often inquire how seminal insights will affect outcome. Consequently, clinicians are beginning to field sophisticated questions regarding molecular testing melanoma, especially regards prognostic therapeutic implications those results. In issue Journal, Nagore et al further contextualize landscape by investigating significance BRAFmutations patients localized disease. Their report comes wake several studies explored profile BRAF mutations advanced commentary, we focus on few most common inquires faced clinic result investigations. Specifically, address question (‘‘Which should undergo testing?’’) followed natural corollaries (‘‘If patient testing, which tissue be sent, test used?’’). Lastly,