092 Subtype-dependent differences in genomic profiles of acral and cutaneous melanoma

Acral melanoma is commonly diagnosed in people of color and has worse prognosis than cutaneous melanoma, even when controlling for tumor stage. Here, we seek to assess differences mutational profiles acral melanomas, which could potentially impact treatment outcomes. Mutational 1273 patients (118 1155 cutaneous) from the American Association Cancer Research Project Genomics Evidence Neoplasia Information Exchange (v10.0) were examined by subtype (acral or stage (primary metastatic). Mutation count distributions analyzed through Wilcoxon rank sum tests gene-specific comparisons assessed using Fisher’s exact test. For both primary metastatic tumors, had significantly more mutations comparable (P < 0.001). Similarly, higher rates BRAF 0.001) GRIN2A patients. In with disease, NRAS prevalent patient those 0.05). Cutaneous also likely have actionable DNA repair genes total mutation counts genes, been shown predict immunotherapy response. such as NRAS, that can be targeted FDA-approved therapies. Our results provide insight into how responses clinical outcomes differ based on subtype.