Table.

Common Genomic Alterations in Melanoma and Clinical Implications

Mutation	Percentage (%)	Clinical features or other comments
BRAF V600	40–50	Confers susceptibility to BRAF/MEK inhibitors, more common on intermittent sun exposed skin
NRAS	15–20	Poor prognosis, may have higher response to immunotherapy
NF1	10–15	More common on sun exposed skin, may have higher response to immunotherapy
KIT	1–2	Confers susceptibility to KIT inhibitors, more common in mucosal (15–20%) and acral melanomas (15–20%)
Atypical BRAF (non-V600)	4–5	May confer susceptibility to MEK or RAF inhibitors
GNAQ/GNA11	80–90 (uveal)
TERT promoter	40–50	Poor prognosis, UV-mediated mutation
CDKN2A	25–35	Deep deletions more common than mutations
PTEN	4–8	May correlate with immune resistance, deep deletions more common than mutations