Acral lentiginous melanoma | Primary Research (KOL's Insight) | Market Intelligence | Epidemiology & Market Forecast-2035

Acral lentiginous melanoma (ALM) is a cutaneous malignant melanoma subtype. It is made up of malignant melanocytes that can become invasive over time. It is frequently diagnosed at a later stage than other types of cutaneous malignant melanoma and in populations with a minimal risk of UV-induced melanomas, emphasising the importance of early screening and detection. Two to three% of all newly diagnosed melanomas are ALMs. The average age of diagnosis for ALM is 62.08 years. All populations experience an increase in ALM incidence with age, and after the age of 80, there is a sharp rise in incidence per person per year. Both men and women are affected in equal numbers, but women are more frequently diagnosed earlier in the disease's course than men. Narrow-margin excisional biopsy is recommended for clinically suspected melanoma, but the proposal assumes that it is impractical in terminal regions. Partial lesion sampling is an acceptable alternative, but the main risk of partial sampling is that it may lead to tissue misdiagnosis.

Description

Acral lentiginous melanoma (ALM) is a cutaneous malignant melanoma subtype. It is made up of malignant melanocytes that can become invasive over time. It is frequently diagnosed at a later stage than other types of cutaneous malignant melanoma and in populations with a minimal risk of UV-induced melanomas, emphasising the importance of early screening and detection. A rare subtype of melanoma that develops on the palms, soles, or beneath the nails is known as acral lentiginous melanoma (ALM). It also goes by the name acral melanoma. ALM frequently takes the form of a dark brown or black, variegated macule in its early stages. In more advanced cases, it may also be nodular and ulcerated. ALM is slow-growing and can take months or years to become invasive, that is, to spread past the basement membrane of the epidermis from which it originated. Lentiginous describes the tumor's radial growth phase, which appears prior to the tumor's invasion of the dermis. Acral lentiginous melanoma (ALM), nodular melanoma (NM), lentigo maligna melanoma (LMM), and superficial spreading melanoma (SSM) are the four primary histological subtypes of cutaneous melanoma (CM).

Acral lentiginous melanoma (ALM) - (Epidemiology)

2-3% of all newly diagnosed melanomas are ALMs. The average age of diagnosis for ALM is 62.08 years. All populations experience an increase in ALM incidence with age, and after the age of 80, there is a sharp rise in incidence per person per year. Both men and women are affected in equal numbers, but women are more frequently diagnosed earlier in the disease's course than men. In contrast to other melanoma subtypes, ALM is more common in non-white patients. According to studies conducted in the United States, it is not the most typical type of melanoma among any racial group. Nevertheless, research from Mexico, Taiwan, and China found that it was the most prevalent subtype in those populations. In two population-based registry studies conducted in the United States, Bradford et al. and Huang et al. discovered that 33-36% of CMM in Black people was attributable to ALM. ALM in Asian/Pacific Islanders ranged from 18 to 23% points of the total CMM. Only 1% of non-Hispanic Whites had ALM, compared to 9% of white people who were Hispanic. ALM incidence rates were significantly lower in Black people, Non-Hispanic Whites, and Asian/Pacific Islanders, at 1.8, 1.8, and 1.1 per 1,000,000 person-years, respectively, than they were in Hispanic Whites, at 2.5 per 1,000,000 person-years. At 5 and 10 years, Black and Hispanic White populations had lower rates of melanoma specific survival (MSS) than white populations; however, when Breslow depth was considered, there was no difference. This is thought to be caused by the advanced presentation stage in these minority groups.

Acral lentiginous melanoma (ALM) - Current Market Size & Forecast Trends

The market for acral lentiginous melanoma is projected to grow steadily, with estimates indicating a value of approximately USD 85 million in 2023 and expected to reach around USD 122.3 million by 2033, reflecting a compound annual growth rate (CAGR) of 3.80% during this period. Overall, the acral lentiginous melanoma market is well-positioned for growth through 2035 as new therapies and diagnostic technologies continue to emerge.

Narrow-margin excisional biopsy is recommended for clinically suspected melanoma, but the proposal assumes that it is impractical in terminal regions. Partial lesion sampling is an acceptable alternative, but the main risk of partial sampling is that it may lead to tissue misdiagnosis. To accurately determine Breslow's depth, samples should be taken from the most nodular part of the lesion. If nail damage is suspected, a sample of the nail matrix should be taken. Nail biopsy surgical techniques are complex and should be referred to a provider skilled in these techniques to ensure an accurate diagnosis. Subsequently, biopsy evaluation by a dermatologist is usually necessary, as ALM findings can be equivocal and require high clinical significance. Other laboratory tests, such as imaging and blood tests, are not recommended if the patient has localized skin disease and is asymptomatic. In later stages of the disease, lactate dehydrogenase is a good predictor of survival in patients with stage IV disease, although it is often not the only indicator of metastatic disease. Radiographic evaluation of occult sarcoidosis or distant metastases has a high false-positive rate. However, if imaging is obtained, chest radiography should be considered a cost-effective option. Unexplained imaging can lead to unnecessary invasive procedures. The American Academy of Dermatology recommends that annual skin examination and palpation of regional lymph nodes are sufficient to assess for recurrence. Sentinel lymph node biopsy has a high prognostic value in moderate and thickened melanoma. Patients with moderate-thickness melanoma and sentinel lymph node metastases have a melanoma-specific survival (CNS) of 62.1% when sentinel node biopsy and complete lymphadenectomy were performed, compared with only 62.1% in controls with post clinical lymphadenectomy. In patients with thickened melanoma who underwent sentinel lymph node biopsy, there was no significant effect on the central nervous system. Despite the studies, these findings remain controversial, and several authors question the survival benefit of sentinel lymph node biopsy.

Report Highlights

Acral lentiginous melanoma (ALM) - Current Market Trends

Acral lentiginous melanoma (ALM) - Current & Forecasted Cases across the G8 Countries

Acral lentiginous melanoma (ALM) - Market Opportunities and Sales Potential for Agents

Acral lentiginous melanoma (ALM) - Patient-based Market Forecast to 2035

Acral lentiginous melanoma (ALM) - Untapped Business Opportunities

Acral lentiginous melanoma (ALM) - Product Positioning Vis-a-vis Competitors' Products

Acral lentiginous melanoma (ALM) - KOLs Insight