[Therapy of melanoma : Current standards and future perspectives]

Melanoma is an aggressive skin cancer with a rising incidence. While early-stage disease can often be managed successfully with surgical intervention alone, advanced stages require immunotherapies and, where appropriate, targeted treatments, which have significantly improved prognosis and overall survival.

This review summarizes current therapeutic standards and emerging developments in melanoma treatment and evaluates their clinical relevance.

A systematic literature search was conducted up to 2025, including guidelines, clinical trials, and review articles on surgical, immunological, and targeted therapies.

Surgical resection remains the standard of care in early-stage melanoma. In advanced stages, immune checkpoint inhibitors (PD‑1, CTLA‑4, LAG-3) reduce recurrence risk in the adjuvant and neoadjuvant settings and improve overall survival in metastatic disease. Local and intralesional therapies (e.g., T‑VEC, Daromun) complement systemic approaches. In BRAF-V600-mutant melanoma, combinations of BRAF and MEK inhibitors are effective and are particularly used in cases of rapidly progressing disease. Novel approaches such as bispecific antibodies, cell-based therapies, and various tumor-specific vaccines show promising results in early clinical studies.

Multimodal treatment strategies have fundamentally improved the prognosis of melanoma. Therapy selection should be individualized based on molecular markers and disease stage. Future developments aim to integrate combination strategies, personalized immunotherapeutic approaches, and the overcoming of resistance mechanisms.