The Utilization of PRAME in the Diagnosis, Prognosis, and Treatment of Melanoma - review

Sep 21, 2026

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Melanoma is a deadly skin cancer whose outcomes have improved through advances in diagnosis and treatment, yet further progress remains essential. Tumor-associated antigens such as PRAME (Preferentially Expressed Antigen in Melanoma) provide opportunities for diagnostic discrimination, prognostic stratification, and targeted immunotherapy. As a cancer testis antigen, PRAME is selectively expressed across cancers including melanoma, supporting tumorigenesis via retinoic acid pathway inhibition, EMT promotion, and immune evasion. This review addresses PRAME’s clinical utility, therapeutic potential, and ongoing challenges including heterogeneity and immune suppression.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages18

Reading Time45 min

AccessFree to download

Introduction

The Biology of PRAME and Other Cancer Testis Antigens

Overview of the PRAME Protein

cells Review The Utilization of PRAME in the Diagnosis, Prognosis, and Treatment of Melanoma Samuel L. Blount 1, Xiaochen Liu 2 and Jeffrey D. McBride 1,2, * Citation: Blount, S.L.; Liu, X.; McBride, J.D. The Utilization of PRAME in the Diagnosis, Prognosis, and Treatment of Melanoma. Cells 2024, 13, 1740. [https://doi.org/](https://doi.org/)[ ](https://doi.org/)[10.3390/cells13201740](10.3390/cells13201740) Academic Editor: Cynthia Simbulan-Rosenthal Received: 16 September 2024 Revised: 10 October 2024 Accepted: 17 October 2024 Published: 20 October 2024 Copyright: © 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ([https://](https://)[ ](https://)[creativecommons.org/licenses/by/](creativecommons.org/licenses/by/)[ ](creativecommons.org/licenses/by/)[4.0/](4.0/)) . 1 College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; [samuel-blount-1@ouhsc.edu](samuel-blount-1@ouhsc.edu) 2 Department of Dermatology, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; [xiaochen-liu@ouhsc.edu](xiaochen-liu@ouhsc.edu) * [Correspondence: jeffrey-mcbride@ouhsc.edu](Correspondence: jeffrey-mcbride@ouhsc.edu) Abstract: Melanoma, a deadly form of skin cancer, has seen improved survival rates due to advancesin diagnosis and treatment, yet the need for further improvement remains critical. Tumor-associated antigens, such as PRAME (Preferentially Expressed Antigen in Melanoma), offer promising avenues for enhanced diagnostic precision, prognostic assessment, and targeted immunotherapy. PRAME, a cancer testis antigen, is selectively expressed in various cancers, including melanoma, and plays a key role in promoting tumorigenesis through inhibition of retinoic acid signaling, epithelial-tomesenchymal transition, and immune evasion. This review explores the diagnostic utility of PRAMEin distinguishing melanoma from benign nevi, its prognostic value in aggressive melanoma subtypes, and its potential as a therapeutic target in cancer vaccines and adoptive T-cell therapies. While PRAMEtargeted therapies face challenges such as tumor heterogeneity and immune suppression, ongoing research aims to overcome these barriers, offering hope for more effective melanoma treatments. Keywords: melanoma; PRAME; cell biology; cancer; immunotherapy 1. Introduction Melanoma, known to develop in part from UV radiation damage of melanocyte DNA or other inherited or acquired mutations, is one of the deadliest forms of skin cancer. The American Cancer Society estimates that in the US, approximately 100,640 new cases of melanoma will be diagnosed in 2024 . Of these, 8290 are expected to die from their cancer. Additionally, melanoma incidence rates are consistently rising. The statistics, however, are not all discouraging. Death rates secondary to melanoma have declined by 6% to 7% per year from 2013 to 2017 . The reductions in death rates can be explained by the improvements in diagnosis and treatment. Over the past three decades, several paradigmshifting therapeutics have been developed for the treatment of cancer, including immune checkpoint inhibitors (ICIs), BRAF and MEK targeted therapies, and cancer vaccines [1] . ICIs, for example, were demonstrated to extend median overall survival from 11.2 months in 2013 to 72.1 months in the CheckMate 067 trial in 2021 [2,3] . Improvements in melanoma screening and rapidity of diagnosis have also contributed to the reduction in death rates. Despite these improvements, the number of deaths remains unacceptably high. Further advancements in melanoma diagnosis and treatment are critical. A particular area of research that poses promising solutions for the diagnosis and treatment of melanoma is the identification of antigen biomarkers. Specifically, investigators are searching for tumor-associ

FAQs

What is PRAME and why is it relevant to melanoma?

PRAME (Preferentially Expressed Antigen in Melanoma) is a cancer testis antigen selectively expressed in cancers, including melanoma. It is investigated for its roles in tumor biology and as a potential biomarker and immunotherapy target.

How can PRAME support melanoma diagnosis?

The review discusses PRAME’s diagnostic utility in distinguishing melanoma from benign nevi, including through immunohistochemistry approaches using antibodies against relevant antigens.

What are the prognostic and therapeutic roles of PRAME?

PRAME is presented as having prognostic value in aggressive melanoma subtypes and as a therapeutic target in cancer vaccines and adoptive T-cell therapies, while acknowledging challenges such as tumor heterogeneity and immune suppression.

Sep 21, 2026

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