Paradigm of biomarkers in metastatic melanoma (Review).

Metastatic melanoma is an aggressive and deadly form of skin cancer, known for its rapid ability to spread to other organs. Melanoma metastasis involves several steps: Local invasion, lymphovascular invasion and proliferation to new sites. This process is facilitated by genetic alterations, interactions with the tumor microenvironment and evasion of the immune system. Despite advances in therapies, the 5-year survival rate remains low at ~22.5%. Notably, current research is focused on identifying patients who may benefit from specific treatments, considering factors such as mutational load and programmed death ligand 1 expression. BRAF inhibitors and immune checkpoint inhibitors have improved survival, although numerous patients do not respond or develop resistance, underscoring the need for novel biomarkers to optimize treatment and monitoring of the disease. In summary, the purpose of the present article is to review the different serological, histological, microRNA and circulating tumor cell biomarkers that have proven useful in the diagnosis, follow-up and prognosis of metastatic melanoma. These biomarkers represent a promising area for research and clinical application, with the aim of offering more precise and personalized treatments.