Therapeutic Approaches to Mucosal Melanoma.

Mucosal melanoma (MM) is a rare and aggressive subtype of melanoma arising from mucosal tissues, with distinct genomic and clinical characteristics compared with cutaneous melanoma (CM). Despite therapeutic advancements, MM remains challenging to treat because of late diagnosis, high heterogeneity, and limited efficacy of conventional therapies. This review synthesizes current knowledge on the genomic landscape of MM and explores the tumor microenvironment that influences treatment resistance. Emerging therapeutic approaches, including neoadjuvant and adjuvant therapies, are critically evaluated. Targeted therapy (eg, BRAF/MEK and KIT inhibitors) demonstrated comparable efficacy in advanced MM and CM. Although immune checkpoint inhibitors show promise in CM, their efficacy in MM is modest, with antiangiogenic-based combination therapies offering potential improvements. Preclinical and ongoing clinical trials underscore the need for personalized treatment strategies on the basis of molecular profiling. This review emphasizes the urgency for further research to address the unmet needs in MM management and improve patient outcomes.