TERT mutations in Malignant Melanoma-Survival Meta-Analysis

Abstract It has long been speculated that the TERT promoter mutation is linked to poor patient survival in malignant melanoma. However, this notion is still in contention, as evidenced by conflicting study results. Therefore, the authors took on a quantitative synthesis in order to gain a better grasp of the role of TERT mutation in melanoma and to further assess the feasibility of taking advantage of the defect as a prospective target in molecular targeted therapy PubMed, EMBASE, Cochrane, MEDLINE, Google Scholar, and other databases were searched with keywords such as "malignant melanoma". "TERT promoter mutation", and "survival". Hazard ratios, in disease‑specific and overall survival, were calculated for each survival-determining variable. Overall, MM patients with mutated TERT promoters were roughly 60% more likely to experience death compared to non-mutated individuals (pooled HR = 1.64). In subgroup analysis, age did not play much role in survival, but male sex, ulceration, acrally located lesions, high Breslow thickness, presence of mitosis, and higher clinical stages were notable factors in poor prognosis. When the TERT promoter is mutated concurrently with other common mutations, such as B-raf, N-ras, and c-kit, the hazard of death is much greater (pooled HR = 2.75). In conclusion, targeting TERT mutation may be one of the missing puzzles for effective targeted therapy in MM, as it influences and interacts with other common mutations.