Current and emerging systemic therapies for cutaneous metastatic melanoma

Expert Opin Pharmacother. 2019 Jun;20(9):1135-1152. doi: 10.1080/14656566.2019.1601700. Epub 2019 Apr 26.

Abstract

Introduction: Melanoma therapies have evolved rapidly, and initial successes have translated into survival gains for patients with advanced melanoma. Both targeted and immune-therapy now have evidence in earlier stage disease. There are many new agents and combinations of treatments in development as potential future treatment options. This highlights the need for a reflection on current treatment practice trends that are guiding the development of potential new therapies.

Areas covered: In this review, the authors discuss the evidence for currently approved therapies for cutaneous melanoma, including adjuvant therapy, potential new biomarkers, and emerging treatments with early phase clinical trial data. The authors have searched both the PubMed and clinicaltrials.gov databases for published clinical trials and discuss selected landmark trials of current therapies and of investigational treatment strategies with early evidence for the treatment of melanoma.

Expert opinion: Significant efficacy has been demonstrated with both immune checkpoint inhibitors and targeted therapies in treating advanced melanoma. A multitude of novel therapies are in development and there is need for instructive biomarker assessment to identify patients likely to respond or be refractory to current therapies, to identify mechanisms of resistance and to direct further treatment options to patients based on individual disease biology.

Keywords: BRAF; CTLA-4; MEK; Melanoma; PD-1; immunotherapy; targeted therapy.

Publication types

  • Review

MeSH terms

  • Combined Modality Therapy / methods*
  • Humans
  • Melanoma / drug therapy*
  • Melanoma / pathology
  • Melanoma, Cutaneous Malignant
  • Skin Neoplasms / drug therapy*
  • Skin Neoplasms / pathology