progressive melanoma from early to late disease in 19 patientstwo patients (CAS-G and SK-H), metastatic disease was dominated by signature 11 or temozolomide signature, deleterious mutations in DNA-mismatch repairgenes, including MSH6 (CAS-G and SK-H), MLH1 (CAS-G), MLH3 (CAS-G and SK-H), and MSH3 (SK-H). The gene discussed is MSH6; the disease is metastatic neoplasm.