Systemic Treatment in Advanced Melanoma

Until 2011, the standard of care in metastatic melanoma was chemotherapy, with a median survival time of about 6 months and only 25% of patients being alive at 1 year. Immune checkpoint inhibitor immunotherapy on the one hand, and MAPK-directed targeted therapies on the other, revolutionized the systemic treatment of advanced melanomas and dramatically improved their outcomes. In this chapter, the results of the main clinical studies leading to the approval of such agents will be reported and discussed, with insights on the implications that these data have for everyday clinical practice.