Managing Metastatic Melanoma in 2022: A Clinical Review

Abstract

Cutaneous melanoma remains the most lethal of the primary cutaneous neoplasms, and although the incidence of primary melanoma continues to rise, the mortality from metastatic disease remains unchanged, in part through advances in treatment. Major developments in immunomodulatory and targeted therapies have provided robust improvements in response and survival trends that have transformed the clinical management of patients with metastatic melanoma. Additional advances in immunologic and cancer cell biology have contributed to further optimization in (1) risk stratification, (2) prognostication, (3) treatment, (4) toxicity management, and (5) surveillance approaches for patients with an advanced melanoma diagnosis. In this review, we provide a comprehensive overview of the historical and future advances regarding the translational and clinical implications of advanced melanoma and share multidisciplinary recommendations to aid clinicians in the navigation of current treatment approaches for a variety of patient cohorts.

Diagnosis and Pattern Identification of Intrathoracic Malignant Melanoma Metastasis: A Retrospective Single Center Analysis

“…On the other hand, we believe that this work focuses on the diagnosis of intrathoracic MM and offers useful practical clues in real life in particular regarding the diagnostic approach, and that it gives also prognostic information, following those already presented in the literature. Indeed, MM has a poor prognosis and, although nowadays there are growing pieces of evidence of efficacious treatment against this pathology [ 33 , 34 ], there is still a need to better understand the underlying mechanisms of the development of lung and other intrathoracic metastasis [ 35 , 36 ], in order to better intercept the predisposed patients and to quickly diagnose them with the proper technique.…”

Skin Cancer Research Goes Digital: Looking for Biomarkers within the Droplets

“…There are many treatment options for skin cancers. Surgical excision is the mainstay of local treatment, whereas radiotherapy (RT) is recommended for patients with medically inoperable, surgically unresectable disease or with high predisposition to metastasis [ 117 , 118 ]. Outcomes are generally inferior with RT without surgical resection and tumors may recur quickly after the treatment [ 119 , 120 ].…”

“…Outcomes are generally inferior with RT without surgical resection and tumors may recur quickly after the treatment [ 119 , 120 ]. Novel systemic approaches, such as targeted therapies and immunotherapies, have revolutionized skin cancer therapy and improved clinical care, especially in the metastatic setting [ 118 , 121 ]. Hedgehog pathway inhibitors (HHi), vismodegib and sonidegib, are relevant examples in this context.…”

Dermatological Autoimmune Considerations of Immune Checkpoint Therapy

“…However, pilot studies have shown that ADs can be managed without discontinuing ICI treatment [ 9 ]. As ICIs have become a cornerstone of treating metastatic melanoma, it is important to know whether patients with ADs can safely receive this immunotherapy [ 10 ].…”