Advances in the Management of Melanoma

Abstract

Purpose of Review

Stage IV melanoma is an aggressive malignancy with the median survival historically being less than 1 year. Approximately 50% of melanomas contain an activating mutation in a targetable component of the mitogen-activated protein kinase (MAPK) pathway called BRAF. Melanoma growth is modulated by activating and inhibitory immune checkpoints. Advances in the management of distantly metastatic and stage III melanoma are reviewed.

Recent Findings

Targeting BRAF signaling in patients with metastatic V600 BRAF mutated melanoma and modulation of immune checkpoints confer survival benefit to patients with distantly metastatic melanoma. CTLA-4 blockade confers survival benefit as adjuvant therapy in patients with stage III melanoma.

Summary

The efficacy of systemic therapy to treat stage IV melanoma is improving. Advances are being made to improve efficacy of adjuvant therapy for high-risk stage III melanoma patients and to determine optimal surgical management of patients with sentinel lymph node-positive melanoma.

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