Progress in the management of melanoma in 2013.

Overview

The treatment of melanoma in 2013 has evolved significantly over the past 2 years, according to presentations at the recent NCCN 18th Annual Conference. Ipilimumab and vemurafenib have prolonged the survival of patients with advanced disease, and the research pipeline continues to evaluate a number of new agents highlighting a tremendous optimism to further improve outcomes. These new treatment options were incorporated into the NCCN Clinical Practice Guidelines in Oncology in 2012. A recent presentation of these guidelines highlighted changes in both the initial management of very thin melanomas and the ongoing importance of targeted agents and immunotherapy in more advanced disease. This presentation included refining the indication for sentinel lymph node biopsy (SLNB), which, according to the updated guidelines, is not recommended for very thin lesions (≤ 0.75 mm). Dr. Daniel G. Coit discussed the rationale for this change during the presentation, and Dr. Anthony J. Olszanski reviewed the evidence for new classes of agents that impact survival.