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Overview of the management of advanced cutaneous melanoma

Jeffrey A Sosman, MD
Section Editor
Michael B Atkins, MD
Deputy Editor
Michael E Ross, MD


Most cases of malignant melanoma are diagnosed at an early stage, when surgical excision can be curative. However, a few patients have metastatic disease at presentation, and some develop metastases after their initial definitive treatment.

High-dose interleukin-2 (IL-2) was the first treatment to modify the natural history of patients with metastatic melanoma and may have resulted in cure in a small fraction of patients. However, its severe toxicity limited its application to carefully selected patients treated at centers with experience in managing the side effects of treatment.

More recent research led to the development of immunotherapy using checkpoint inhibitors (the anti-programmed cell death 1 [PD-1] antibodies [pembrolizumab, nivolumab] and the anti-cytotoxic T-lymphocyte-associated protein 4 [CTLA-4] antibody [ipilimumab]) and targeted therapy (inhibition of the BRAF and/or MEK genes). Both checkpoint inhibitor immunotherapy and targeted therapy prolong progression-free and overall survival compared with chemotherapy, which has not been proven to increase overall survival.

This topic provides an overview of treatment options for patients with metastatic melanoma, along with their applications in different clinical settings. More detailed discussions of each of the specific treatment options are presented separately:

(See "Surgical management of metastatic melanoma".)

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Literature review current through: Nov 2017. | This topic last updated: Sep 19, 2017.
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