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Systemic Therapy for Melanoma: What Surgeons Need to Know

Ashlee N Seldomridge1, Roi Weiser1, Ashley M Holder1

  • 1Department of Surgical Oncology, University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA.

Surgical Oncology Clinics of North America
|May 24, 2025
PubMed

Immune checkpoint inhibitors and targeted therapies (BRAF/MEK inhibitors) have transformed the care of patients with stage IV melanoma, now with 5-year overall survival rates around 50%. Surgeons should be acquainted with these drugs, the multidisciplinary considerations of their use, and the unique immune-related adverse events (irAEs) they can cause. In this review, we discuss systemic therapies for cutaneous melanoma, including the biology of immune checkpoint inhibition, treatment indications, and toxicities. We also explain how these irAEs and other toxicities can impact surgical planning and perioperative management.

Keywords:
Immune checkpoint inhibitorsImmune-related adverse eventsIpilimumabMelanomaNivolumabPembrolizumabRelatlimabTalimogene laherparepvec

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