New therapies in the treatment of melanoma.

INTRODUCTION: Therapies targeting immune checkpoints (CTLA-4) and the MAP kinase signaling pathway (RAS/RAF/MEK/ERK) have transformed the treatment of advanced melanoma in the past year. Agents aimed at other therapeutic targets of interest are being actively evaluated in the clinic. AREAS COVERED: Areas of active therapeutic interest in melanoma include immunotherapy, molecularly targeted therapy and chemotherapy; combinations of these modalities are now under systematic exploration. EXPERT OPINION: The evaluation of patients with melanoma now includes the molecular profiling of tumor mutations in the BRAF, as well as c-Kit, NRAS and other genes that have been discovered to be drivers of different subsets of the disease. The analysis of the host immunological response to melanoma is equally important, as a basis for the development of immunotherapies that have been of value to melanoma patients in the adjuvant arena, as well as for therapy of metastatic disease. The understanding of these two facets of the disease will provide a more rational basis for the delivery of individualized therapy for the disease both in its advanced setting, and in the adjuvant arena, in the future.