Poly (ADP-Ribose) Polymerase inhibitors (PARPi) have been implicated in recent years as viable treatment options for melanoma patients with homologous recombination deficiency (HRD) status. However, patient selection for PARPi therapy remains challenging as there remains many genetic and epigenetic factors that could contribute to HRD status.

Here, we report a case of an advanced acral melanoma patient, a more aggressive form of melanoma, with disease progression following standard-of-care treatment who demonstrated a near-complete response to PARPi treatment.