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KEY CONCEPTS

KEY CONCEPTS

  • Image not available. Cutaneous melanoma is an increasingly common malignancy, but it is a cancer that can be cured if detected early. Public education about screening and early detection is one strategy to control the increase in incidence and the mortality associated with cutaneous melanoma.

  • Image not available. Surgical resection can cure patients with early-stage melanoma.

  • Image not available. Adjuvant therapy should be considered in patients with locally advanced disease; recommended options include IFN-α2b, ipilimumab or participation in a clinical trial.

  • Image not available. Single agent chemotherapy offers limited benefit in metastatic melanoma. Combination chemotherapy has not been shown to be superior to single-agent therapy.

  • Image not available. Advances in immunotherapy with ipilimumab, pembrolizumab, and nivolumab have led to long durable responses in some patients with metastatic melanoma and have significantly impacted overall survival.

  • Image not available. The immune-related toxicities associated with immunotherapy can be severe and life-threatening. Consequently, the use of these agents warrants appropriate patient selection, close monitoring and toxicity management by an experienced healthcare team.

  • Image not available. As the biology of melanoma has been further delineated, a growing number of potential targets for drug therapy have been identified. BRAF mutations appear in up to 70% of melanoma patients. The use of BRAF inhibitors with or without MEK inhibitors has been shown to improve overall survival in patients with this mutation.

  • Image not available. Treatment of melanoma is determined by many factors. As the number of treatment options for patients with metastatic melanoma grows, it will be important to consider disease- and patient-related aspects when determining appropriate therapy.

Skin cancer is the most common malignancy worldwide and is associated with chronic ultraviolet (UV) exposure. The two types of skin cancer are nonmelanoma skin cancers (NMSCs) and melanoma. Although NMSCs are the most common malignancy of the skin, cutaneous melanoma accounts for up to 75% of all skin cancer-related deaths. Melanoma cases are increasing globally with the highest rates found in Australia, New Zealand, North America, and Northern Europe. Melanoma is the sixth most common cancer in the United States. The incidence of melanoma has steadily increased in the United States since the 1970s, and for the last decade, has raised an average of 1.4% each year.1 When detected early, patients generally have a good prognosis. With the rise in the number of melanoma skin cancers and the associated mortality, it is essential to consider issues of care beyond that of disease treatment. Skin cancer prevention and screening have a major impact on public health, and on the success of treatment, for those individuals diagnosed with both NMSC and melanoma. Skin cancers tend to occur more frequently in older individuals with a median age of diagnosis 63 years old.1 Therefore, as the population continues to age, effective strategies to prevent, detect, and treat individuals with these cancers are necessary. An understanding of the biology of melanoma has led to the development of targeted therapies toward somatic mutations and immunotherapies, which have shown improved outcomes in patients with advanced melanoma.

EPIDEMIOLOGY

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