Immunotherapy for Melanoma: A Concise Clinical Review for Australasian Practice

Immunotherapy has transformed the management of melanoma and is now a central component of care for patients with high-risk, unresectable, and metastatic disease. Immune checkpoint inhibitors targeting programmed death 1 (PD-1), cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4), and lymphocyte activation gene 3 (LAG-3) enhance antitumour immune responses and have resulted in substantial improvements in survival, with durable disease control in a proportion of patients. In Australia and New Zealand, immunotherapy is routinely used across the melanoma disease continuum, including neoadjuvant, adjuvant, and metastatic settings, supported by evolving regulatory approvals and funding pathways. This review summarises current immunotherapy approaches to melanoma, with a focus on how these therapies are used in routine Australian practice, including mechanisms of action, indications across disease stages, commonly used agents, special melanoma subtypes, benefits and limitations of treatment, immune-related adverse events, particularly cutaneous toxicities, and emerging therapies. The role of dermatologists within multidisciplinary melanoma care is highlighted.