Immunotherapy for metastatic melanoma—from little benefit to first-line treatment

Summary At the turn of past century, unresectable metastatic melanoma was primarily treated with different chemotherapeutic agents, such as dacarbazine, only poor efficacy. Immunotherapeutic interleukin‑2 or adjuvant interferon alpha, were used modest results but frequent side effects. In last 10 years, modern immunotherapy using checkpoint inhibition has dramatically changed treatment landscape and is now considered first-line for stage IV melanoma. Consequently, median overall survival increased from 9.1 months dacarbazine to up 72.1 current gold standard ipilimumab + nivolumab first-line. 2023, in Europe, anti-PD1 antibodies pembrolizumab are licensed setting combination therapies relatlimab approved setting. Nevertheless, despite tremendous progress two decades, at least 50% our patients still die. Currently, research focuses on combining other drugs cancer vaccines, BRAF/MEK inhibition, tyrosine kinase inhibitors histone deacetylase inhibitors.