# A comprehensive review and case series of adjuvant and neoadjuvant therapies in acral melanoma with emerging insights from CT DNA testing

**Authors:** Adityanarayan Rao, Akash Mathavan, Akshay Mathavan, Bentley Doonan

PMC · DOI: 10.3389/fonc.2025.1619248 · 2025-10-14

## TL;DR

This paper reviews and analyzes pre- and post-surgery immunotherapy for acral melanoma, a rare skin cancer, and explores how blood tests tracking tumor DNA can improve treatment decisions.

## Contribution

The study provides a case series and review of neoadjuvant and adjuvant immunotherapy in acral melanoma, alongside insights from circulating tumor DNA testing.

## Key findings

- A case series of five patients showed outcomes of neoadjuvant and adjuvant immunotherapy for acral melanoma.
- Circulating tumor DNA testing may help track treatment response and personalize therapy.
- The study suggests that treatment strategies may need to be tailored for acral melanoma's unique genetic profile.

## Abstract

Acral melanoma is a rare but aggressive type of skin cancer that appears on the hands, feet, and under the nails. Unlike other melanomas, it is not linked to sun exposure and has unique genetic features that may require different treatment strategies. This research aims to explore whether immunotherapy given before surgery (neoadjuvant therapy) or after surgery (adjuvant therapy) is more effective in improving patient outcomes.

By analyzing existing studies, we hope to understand which approach better reduces the risk of cancer returning and improves survival.

Further, we assessed the clinical course and outcomes of adjuvant and neoadjuvant immunotherapy through a case series of five patients who underwent either intervention. Additionally, we examine how new blood tests that detect tumor DNA could help track treatment response and personalize therapy.

Our findings may guide doctors in selecting the best treatment plans, leading to improved care for patients with this challenging disease and advancing research into more effective therapies.

## Linked entities

- **Diseases:** acral melanoma (MONDO:0003865)

## Full-text entities

- **Diseases:** cancer (MESH:D009369), skin cancer (MESH:D012878), Acral melanoma (MESH:D008545)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Figures

1 figure with captions in the complete paper: https://tomesphere.com/paper/PMC12558761/full.md

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Source: https://tomesphere.com/paper/PMC12558761