Melanoma: A Model of Immunotherapy Success

Melanoma is a malignant tumor of melanocytes, most often caused by UV exposure. While once lethal in its metastatic form, it has become a showcase for breakthroughs in immunotherapy and targeted therapy.

Immunotherapy

Checkpoint inhibitors have revolutionized melanoma care:

• ●  Anti-PD-1 agents: nivolumab, pembrolizumab
• ●  Anti-CTLA-4: ipilimumab (often used in combination with PD-1 blockade)
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These agents are used in metastatic, adjuvant, and even neoadjuvant settings.

Targeted Therapy

Approximately 40–50% of melanomas harbor BRAF V600E/K mutations. Targeted therapies include:

• ●  BRAF inhibitors: dabrafenib, vemurafenib
• ●  MEK inhibitors: trametinib, cobimetinib These are used in combination and offer rapid tumor regression.
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Future Directions

• ●  Neoadjuvant immunotherapy is showing promising pathologic response rates.
• ●  LAG-3 inhibitors (e.g., relatlimab) add new depth to checkpoint blockade strategies.
• ●  Adoptive cell therapy and intralesional immunotherapy are under investigation.
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