Early evolution and punctuated genomic events in acral melanoma
Why do acral melanomas show early, complex amplifications ('hailstorms') and an order of events distinct from sun‑exposed melanomas?
Acral melanomas frequently lack UV signatures yet carry complex, high‑level focal amplifications that arise early in tumour development. Our 2024 integrative sequencing of multiple progression stages from individual patients shows that these clustered copy‑number transitions—termed 'hailstorms'—are commonly present in in situ lesions and are shared across stages, indicating a punctuated origin.
Understanding the timing and distribution of these events can reveal the initiating genomic instability and nominate early biomarkers for detection in high‑risk patient groups. We combine multi‑regional exome and whole‑genome sequencing with phylogenetic inference and spatial transcriptomics to map clonal architecture across progression stages and anatomical fields.




