A Review of Current Treatment Options for Stage III and Stage IV Metastatic Melanoma

The incidence of melanoma has increased for decades, and while surgical treatment of early stage disease is often curative, metastatic disease continues to have significant morbidity and mortality and carries a high associated health burden and economic cost. An expanding number of dermatologists are playing a key role in coordinating the care of patients with advanced melanoma, including in the setting of multidisciplinary melanoma clinics, many of which are anchored in dermatology departments. Advances in the understanding of the genetic and immunoregulatory aspects of melanoma development and progression have yielded a wave of novel therapeutics that has made significant impact on the approach to patients with metastatic disease. Frequently updated management guidelines and unfamiliarity with approved adjuvant treatment options can act as a roadblock for dermatologists seeking to effectively coordinate care and establish goals for treatment in patients with stage II/III and IV disease. This review paper discusses current knowledge of therapy options, including immunotherapy, targeted therapies, radiation therapy, intralesional therapy, and chemotherapy specific for stage III and IV melanoma.