The potential of BRAF-associated non-coding RNA as a therapeutic target in melanoma

ABSTRACT

Introduction: The advent of targeted therapies and immune checkpoints inhibitors has enhanced the treatment of metastatic melanomas. Despite striking improvements of patients’ survival, drug resistance continues to limit the efficacy of such treatments. Genetic and nongenetic/adaptive mechanisms of resistance could be involved; in the latter mechanism, noncoding RNAs (ncRNAs) are emerging as key players.

Areas covered: This article outlines the current knowledge of ncRNA involvement in BRAF-mutant melanomas and the development of resistance to targeted/immunotherapies. We also discuss how ncRNAs can be exploited for the development of therapeutic and diagnostic approaches.

Expert opinion: ncRNAs can be envisaged as powerful diagnostics and therapeutics. Despite progress in our knowledge about their deregulation in cancer, it is still difficult to derive universal and robust ncRNAs unique signatures of malignancy for diagnostic purposes, which need validation in large cohort of patients. Also, ncRNA specific targeting to melanoma cells in vivo requires the development of improved systemic delivery tools. In this regard, the development of stable nanodelivery particles seems to offer renewed hope for success in the clinic.

KEYWORDS:

• Melanoma
• ncRNA
• BRAF
• mechanism of resistance
• non-coding RNA

Article Highlights

• Targeted therapies and immune checkpoint inhibitors have changed melanoma natural history

• Innate and acquired drug resistance limits the efficacy of the above treatments

• ncRNAs are emerging as key modulators of resistance

• ncRNAs constitute non-invasive biomarkers with potential diagnostic/prognostic implications

ncRNAs offer therapeutic options for the management of melanoma

This box summarizes key points contained in the article.

Declaration of interest

P. Ascierto has a consultant/advisory role for Bristol-Meyers Squibb, Roche-Genentech, Merck Sharp & Dohme, Novartis, Amgen, Array, Merck Serono, Pierre-Fabre, Incyte, NewLink Genetics, Genmab, MedImmune, AstraZeneca, Syndax, Sun Pharma, Sanofi, Idera, and Ultimovacs. He also received research funds from Bristol-Meyers Squibb, Roche-Genentech, and Array. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose

Additional information

Funding

This paper was funded by Italian Association for Cancer Research (AIRC) [grant numbers IG15216, IG19865 and IG17009] awarded to G. Ciliberto and R. Mancini, respectively. L. Fattore received an FIRC (Federazione Italiana Ricerca sul Cancro) fellowship from 2015 to 2017 and is currently a recipient of an FUV (Fondazione Umberto Veronesi) post-doctoral fellowship.