RT Book, Section A1 O’Bryant, Cindy L. A1 Poust, Jamie C. A2 DiPiro, Joseph T. A2 Talbert, Robert L. A2 Yee, Gary C. A2 Matzke, Gary R. A2 Wells, Barbara G. A2 Posey, L. Michael SR Print(0) ID 1145215159 T1 Melanoma T2 Pharmacotherapy: A Pathophysiologic Approach, 10e YR 2017 FD 2017 PB McGraw-Hill Education PP New York, NY SN 9781259587481 LK accesspharmacy.mhmedical.com/content.aspx?aid=1145215159 RD 2024/03/28 AB KEY CONCEPTS 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. Surgical resection can cure patients with early-stage melanoma. Adjuvant therapy should be considered in patients with locally advanced disease; recommended options include IFN-α2b, ipilimumab or participation in a clinical trial. Single agent chemotherapy offers limited benefit in metastatic melanoma. Combination chemotherapy has not been shown to be superior to single-agent therapy. 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. 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. 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. 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.