Precision oncology in advanced melanoma: molecular landscapes and personalized therapy recommendations from the Molecular Tumor Board Freiburg.

@article{lowinus2026precision,
  title = {{Precision oncology in advanced melanoma: molecular landscapes and personalized therapy recommendations from the Molecular Tumor Board Freiburg.}},
  author = {T Lowinus and V Schipperges and P Metzger and T Brummer and U Matysiak and E P Dopfer and M E Hess and M Fahrner and T Pauli and A Blaumeiser and H Becker and J Kuehn and M Rassner and J Falkenstein and H Bertemes and P Bovio and N Pinter and S Cysar and S Lehr and R Wäsch and L Gräßel and K Eyerich and A M Schultheis and O Schilling and S Lassmann and M Werner and A L Illert and J Duyster and R Zeiser and C C Miething and M Boerries and F Meiss and D Rafei},
  journal = {NPJ precision oncology},
  year = {2026},
  month = oct,
  doi = {10.1038/s41698-026-01763-w},
  url = {https://europepmc.org/article/MED/42907470},
  note = {CC BY},
}

TY  - JOUR
TI  - Precision oncology in advanced melanoma: molecular landscapes and personalized therapy recommendations from the Molecular Tumor Board Freiburg.
AU  - T Lowinus
AU  - V Schipperges
AU  - P Metzger
AU  - T Brummer
AU  - U Matysiak
AU  - E P Dopfer
AU  - M E Hess
AU  - M Fahrner
AU  - T Pauli
AU  - A Blaumeiser
AU  - H Becker
AU  - J Kuehn
AU  - M Rassner
AU  - J Falkenstein
AU  - H Bertemes
AU  - P Bovio
AU  - N Pinter
AU  - S Cysar
AU  - S Lehr
AU  - R Wäsch
AU  - L Gräßel
AU  - K Eyerich
AU  - A M Schultheis
AU  - O Schilling
AU  - S Lassmann
AU  - M Werner
AU  - A L Illert
AU  - J Duyster
AU  - R Zeiser
AU  - C C Miething
AU  - M Boerries
AU  - F Meiss
AU  - D Rafei
PY  - 2026
DA  - 2026/10/21
JO  - NPJ precision oncology
DO  - 10.1038/s41698-026-01763-w
UR  - https://europepmc.org/article/MED/42907470
AB  - Immune checkpoint inhibitors (ICIs) and BRAF/MEK kinase inhibitors have substantially improved survival in advanced melanoma; however, therapeutic resistance and severe toxicities underscore the ongoing need for alternative strategies. Here, we evaluate the clinical utility of multi-omic profiling, biomarker-stratified recommendations, and survival outcomes within a prospective cohort of 98 patients with advanced cutaneous or uveal melanoma evaluated by the Molecular Tumor Board Freiburg (MTB-FR) between 2021 and 2024. Completed profiling revealed at least one potential actionable target beyond classical BRAF V600 mutations in 83.8% of cases. Alterations in NRAS, atypical BRAF variants, CDK4/6 pathway amplifications, and DNA-damage response (DDR) gene mutations most frequently guided board recommendations. Biomarker-stratified therapies were recommended for 68.4% of patients, and personalized immunotherapy combinations for 72.4%. The treatment implementation rate was 33.8% (n = 27), achieving an overall disease control rate (DCR) of 42.9% and an overall response rate (ORR) of 10.7%. These findings demonstrate that comprehensive molecular profiling in a real-world setting uncovers actionable alterations, providing viable subsequent treatment avenues that may optimize outcomes for heavily pretreated melanoma patients beyond established standards of care. Ultimately, prospective, randomized, biomarker-driven trials remain essential to validate whether these individualized diagnostic strategies translate into a reproducible survival benefit.
SN  - 2397-768X
ER  -