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1. Surgical treatment
The main curative approach for early-stage melanoma. Excision margins are determined by tumor thickness and risk, aiming to achieve oncologic clearance while minimizing complications.
2. Minimally invasive local therapies
Local ablative or focal approaches (e.g., cryotherapy or photodynamic therapy) are not standard curative treatments for most melanomas and are generally limited to highly selected cases or palliative intent. Their use must be determined by a specialist team after pathological confirmation and staging.
3. Neoadjuvant therapy
Preoperative systemic therapy may be used to shrink tumors and improve resectability in selected high-risk stage III patients, potentially reducing recurrence risk.
4. Immunotherapy
PD-1 inhibitors and, in selected patients, CTLA-4–based regimens can activate anti-tumor T-cell responses and improve survival in advanced disease; commonly used as first-line systemic options depending on clinical context.
5. Targeted therapy
For patients with actionable mutations (most commonly BRAF V600), combined BRAF and MEK inhibition is effective; molecular testing is required to identify eligible patients.
6. Radiotherapy
Used mainly for palliation or local control in specific settings (e.g., brain metastases). Stereotactic techniques can deliver precise doses while limiting exposure to surrounding tissue; toxicity risks (including ulceration in certain sites) require careful planning.
7. Chemotherapy
Agents such as dacarbazine have limited efficacy and higher toxicity compared with modern systemic therapies; generally reserved for situations where other options are unsuitable or unavailable.
8. Regional perfusion chemotherapy
Isolated limb perfusion/infusion can deliver high local drug concentrations for in-transit metastases or limb-confined progression, helping achieve local disease control.
9. TIL therapy
Tumor-infiltrating lymphocyte (TIL) therapy involves expanding a patient’s immune cells ex vivo and reinfusing them. It represents a personalized option for selected advanced cases, often after prior systemic therapy.
10. Oncolytic virus therapy
Oncolytic viruses can selectively infect tumor tissue and stimulate systemic anti-tumor immunity. They may be considered in selected patients, typically within specific clinical indications and protocols.
Jinshazhou Hospital of Guangzhou University of Chinese Medicine emphasizes that melanoma is the most aggressive form of skin cancer, with a rising global incidence and a strong tendency for early metastasis; delayed diagnosis is associated with poor outcomes. Early detection, standardized treatment, and continuous care are essential to improving prognosis. Patients are advised to rely on a multidisciplinary team and develop an individualized plan based on disease stage and molecular characteristics to achieve the best possible outcomes.
1. Surgical treatment
The main curative approach for early-stage melanoma. Excision margins are determined by tumor thickness and risk, aiming to achieve oncologic clearance while minimizing complications.
2. Minimally invasive local therapies
Local ablative or focal approaches (e.g., cryotherapy or photodynamic therapy) are not standard curative treatments for most melanomas and are generally limited to highly selected cases or palliative intent. Their use must be determined by a specialist team after pathological confirmation and staging.
3. Neoadjuvant therapy
Preoperative systemic therapy may be used to shrink tumors and improve resectability in selected high-risk stage III patients, potentially reducing recurrence risk.
4. Immunotherapy
PD-1 inhibitors and, in selected patients, CTLA-4–based regimens can activate anti-tumor T-cell responses and improve survival in advanced disease; commonly used as first-line systemic options depending on clinical context.
5. Targeted therapy
For patients with actionable mutations (most commonly BRAF V600), combined BRAF and MEK inhibition is effective; molecular testing is required to identify eligible patients.
6. Radiotherapy
Used mainly for palliation or local control in specific settings (e.g., brain metastases). Stereotactic techniques can deliver precise doses while limiting exposure to surrounding tissue; toxicity risks (including ulceration in certain sites) require careful planning.
7. Chemotherapy
Agents such as dacarbazine have limited efficacy and higher toxicity compared with modern systemic therapies; generally reserved for situations where other options are unsuitable or unavailable.
8. Regional perfusion chemotherapy
Isolated limb perfusion/infusion can deliver high local drug concentrations for in-transit metastases or limb-confined progression, helping achieve local disease control.
9. TIL therapy
Tumor-infiltrating lymphocyte (TIL) therapy involves expanding a patient’s immune cells ex vivo and reinfusing them. It represents a personalized option for selected advanced cases, often after prior systemic therapy.
10. Oncolytic virus therapy
Oncolytic viruses can selectively infect tumor tissue and stimulate systemic anti-tumor immunity. They may be considered in selected patients, typically within specific clinical indications and protocols.
Jinshazhou Hospital of Guangzhou University of Chinese Medicine emphasizes that melanoma is the most aggressive form of skin cancer, with a rising global incidence and a strong tendency for early metastasis; delayed diagnosis is associated with poor outcomes. Early detection, standardized treatment, and continuous care are essential to improving prognosis. Patients are advised to rely on a multidisciplinary team and develop an individualized plan based on disease stage and molecular characteristics to achieve the best possible outcomes.