Black patients lack granular data in large population registries, limiting insight into risk factors.

New research published in JAMA Dermatology provides crucial patient-level and tumor-level insights into melanoma in Black patients that has been lacking in large registiries.

The case series was conducted from January 2006 to October 2022 at two tertiary care centers (University of Texas Southwestern Medical Center and Parkland Health) and included 48 Black patients with melanoma.

Of 40 primary cutaneous melanomas in the study, 30 (75%) of primary cutaneous melanomas were located on acral skin, despite just 10 of 30 (33%) being histologically classified as acral lentiginous melanomas. Those with nonacral cutaneous melanomas had a higher likelihood of being immunocompromised or have a personal history of cancer. The study also showed that 13 (27%) of the patients developed stage IV disease, and 12 of 13 died due to disease progression. No patients with nonacral cutaneous melanomas experienced distant metastases or succumbed to melanoma.

Patients who had advanced acral melanoma, mucosal/ocular melanoma, and melanoma of unknown primary tended to have the poorest outcomes, lacking actionable sequence variations and showing resistance to immunotherapy.

“This single-institution case series highlights several features of melanoma in Black patients that have not been captured in existing population-level registries, including precise anatomic sites, immune status, family and personal cancer history, and genetics,” the authors wrote. “Multi-institutional registries would improve understanding of melanoma in Black patients.”

Source: Wix SN, Brown AB, Heberton M, Adamson AS, Gill JG. Clinical Features and Outcomes of Black Patients with Melanoma. JAMA Dermatology. doi:https://doi.org/10.1001/jamadermatol.2023.5789