Over the past several decades, the incidence of melanoma has increased.
Although surgery remains the primary treatment modality for localized early-stage
lesions, melanoma is often diagnosed following locoregional and distant disease
spread. Prognosis for advanced stage disease is dismal as one would expect; however,
nowadays, the myriad of systemic therapies have allowed for improvements in disease
free and overall survival. Such systemic treatment approaches include chemotherapy,
immunotherapy, and molecularly targeted agents. Since the time of the approval of
dacarbazine by the Food and Drug Administration for the treatment of metastatic
melanoma in 1975, other agents have gained approval including interleukin-2, immune
checkpoint inhibitors such as ipilimumab (anti-CTLA-4), and others. More recently,
studies suggest that combination regimens of the aforementioned approaches may
further improve outcomes when compared to monotherapy. Herein, the authors provide
an up-to-date comprehensive review on the chemotherapeutic, immunologic, and
molecularly targeted therapy approaches to the treatment of advanced melanoma.
Keywords: Advanced Stage, Anti-PD-1, Anti-CTLA-4, Anti-PD-L1, Chemotherapy,
Dacarbazine, Immune Checkpoint, Immunotherapy, Interleukin-2, Melanoma, Metastatic, Systemic, Targeted Therapy, Vaccine.