Source: CancerNetwork, May 2025
Evolution of Melanoma Treatment Paradigms
Key Discussion Points:
- The melanoma treatment landscape has evolved dramatically over the past decade with immunotherapy emerging as a frontline approach
- Dual checkpoint blockade has demonstrated superiority over monotherapy in metastatic (but not adjuvant) setting
- DREAMseq trial established that upfront dual checkpoint blockade is superior to frontline targeted therapy (BRAF/MEK inhibition)
Key Points for Physicians:
- For BRAF-mutated melanoma, immunotherapy is generally preferred first-line over targeted therapy based on clinical trial evidence
- Consider starting with BRAF/MEK inhibitors in symptomatic patients with high LDH, rapidly progressing disease, or when rapid response is needed