Age reshapes selection on melanoma driver mutations.

In a cohort of 5,472 melanomas, the selective advantage of major driver mutations shifts with age: BRAF V600E advantage declines sharply while NRAS Q61 gains advantage.

• Why it matters: Aging raises melanoma risk, but it was unclear whether older tumors evolve mainly through changing mutation rates, changing microenvironment-driven selection, or both.
• What they did: The study analyzed 5,472 melanomas, estimating age-dependent selection on individual variants while accounting for neutral mutation rates and their modest age increase.
• The result: Neutral mutation rates rose only modestly with age, while ultraviolet damage stayed predominant; however, selection on drivers was strongly age dependent, and this supports age-conscious evaluation of biomarkers and therapies.

AI summary of the abstract · may contain errors · not medical advice · read the paper.