Immunotherapy for advanced melanoma: current situation in Japan

Area of Science:

• Oncology
• Immunology
• Dermatology

Background:

• Immune checkpoint inhibitors (ICIs) have significantly improved long-term survival for advanced melanoma patients.
• Anti-programmed death-1 (PD-1) monotherapy and combination anti-PD-1/cytotoxic T-lymphocyte-associated protein 4 (CTLA4) therapy show efficacy, but challenges remain.
• Acral, mucosal, and uveal melanomas exhibit lower response rates to ICIs compared to cutaneous melanoma.

Purpose of the Study:

• To review the clinical efficacy of immunotherapy in advanced melanoma.
• To examine the response of acral, mucosal, and uveal melanoma subtypes to ICIs.
• To discuss durable responses after anti-PD-1 therapy cessation and treatment strategies for recurrence.

Main Methods:

• Systematic review of current evidence on immunotherapy for advanced melanoma.
• Analysis of previous studies focusing on specific melanoma subtypes (acral, mucosal, uveal).
• Discussion of recent findings on treatment cessation and recurrence management.

Main Results:

• ICIs offer improved survival in advanced melanoma, particularly cutaneous types.
• Specific melanoma subtypes (acral, mucosal, uveal) demonstrate limited responsiveness to current ICI treatments.
• Data on optimal duration of anti-PD-1 therapy and management of relapsed or refractory disease are still evolving.

Conclusions:

• Immunotherapy has transformed advanced melanoma treatment, yet challenges persist for specific subtypes and treatment discontinuation.
• Further research is needed to optimize ICI therapy duration and develop effective strategies for patients who relapse.
• Understanding durable responses and managing recurrence are critical for improving long-term outcomes in advanced melanoma.