Systemic Therapy for Melanoma

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Key Points ➤ The clinical burden associated with the treatment of melanoma has been increasing due to rising incidence in most countries worldwide. ➤ In less than ten years, nine new drugs have been approved for unresectable melanoma, along with four new approvals in the adjuvant setting. ➤ Overall survival for melanoma is improving equally rapidly, with dramatic increases in long-term survival observed from administration of these new therapies. Treatment Neoadjuvant Systemic Therapy Cutaneous Melanoma Eligible for Resection ➤ Recommendation 1. No recommendation can be made for or against the routine use of neoadjuvant therapy for adults with resectable regional or distant metastatic cutaneous melanoma at this time. Patients should be offered or referred for enrollment in clinical trials where possible. (L) Adjuvant Systemic Therapy Resected (Stage II, III, IV) Cutaneous Melanoma ➤ Recommendation 2.1. Adjuvant pembrolizumab, nivolumab, or combination dabrafenib and trametinib therapy should NOT be offered to patients with resected stage II melanoma outside of enrollment in a clinical trial. (Moderate recommendation; IC-L)

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