About the book
With an incidence increasing over the past 30 years, cutaneous melanoma, representing about 1% of skin cancers, is causing the majority of skin cancer-related death. With four major genomic subtypes, BRAF-mutated, RAS-mutated, NF1-mutated and the triple wild-type subtype, targeted therapies only demonstrated efficacy and received approval for the BRAF-mutant melanoma subtype. Although combination therapies with dual BRAF/MEK inhibition have shown improvement in clinical outcomes over a single-agent inhibitor alone, a large majority of patients eventually acquire resistance to therapy and relapse, through numerous mechanisms. Immune checkpoint inhibitors (ICIs), acting through CTLA-4 targeting and PD1 blockade, are now part of both first- and subsequent-line treatment options, and their use has resulted in dramatic improvements in outcomes, shifting survival from months to years for some melanoma patients.
Furthermore, the approval of these ICIs in the adjuvant setting for resectable melanoma represents further major advances for patients with locally advanced disease and involvement of regional lymph nodes; ICIs are effective regardless of BRAF status, placing ICIs as equally weighted first-line therapy options, along with targeted therapy, for patients with BRAFV600 mutation.
In this book, we will provide recent breakthroughs in melanoma development and metastasis, and discuss current treatment modalities and ongoing clinical trials.