Distinction Between Cutaneous and Uveal Melanoma in Neoadjuvant Therapy

Evidence Base for Cutaneous Melanoma

• The NCCN guidelines highlight that cutaneous melanoma responds to immune‑checkpoint inhibitors (e.g., anti‑PD‑1) and BRAF/MEK targeted agents, and robust neoadjuvant trial data support these approaches【1】【2】【3】.

Molecular Profile of Uveal (Choroidal) Melanoma

• Uveal melanoma is driven by distinct genetic alterations (e.g., BAP1, SF3B1, EIF1AX mutations) rather than the BRAF mutations common in cutaneous disease, underscoring its different biology and therapeutic responsiveness【1】.

Guideline Recommendation Not to Extrapolate Cutaneous Data

• The NCCN guidelines explicitly advise against applying neoadjuvant strategies validated in cutaneous melanoma to choroidal/uveal melanoma, because the two entities have separate disease pathways and treatment paradigms【1】【2】【3】.