Systemic Therapies for Metastatic Melanoma.

Systemic therapies for advanced local and metastatic melanoma, typically used for Stage IIB or higher, can broadly be classified into 2 categories: immunotherapies and targeted therapies. Immunotherapies work by inhibiting immune checkpoints (ie, disinhibiting immune checkpoint blockade), resulting in greater T-cell anti-tumor activity. Targeted therapies, reserved for BRAF V600-mutant melanomas, are orally-available small molecules that inhibit the function of activated oncoproteins such as BRAF and MEK. These systemic medications carry a significant risk for adverse effects, often affecting the cutaneous, gastrointestinal and endocrine systems.