Management of In-Transit Metastatic Melanoma

Approximately 10% of patients with melanoma develop in-transit disease (ITM). Although resection may be performed in patients with limited, fully resectable disease, many patients with ITM present with bulky, unresectable disease, which can pose a significant therapeutic challenge. Regional perfusion chemotherapy procedures and intralesional therapy have high response rates and can provide durable locoregional control while limiting systemic toxicity. Systemic therapies, including immune checkpoint inhibitors and targeted therapies, may also be used especially in patients with concomitant distant metastatic disease. In this article, we review the available treatment options for ITM.