The Treatment Revolution of Melanoma: What Came Before Immunotherapy?

Abstract

Melanoma is a biologically complex malignancy characterized by rapid progression, strong metastatic potential, and notable resistance to conventional systemic therapy. The therapeutic landscape of melanoma has been significantly reshaped by continuing advances in molecular oncology and tumor immunology in the past few decades. This review examines the major biological mechanisms involved in the development and progression of melanoma. Current treatment strategies are discussed, with particular focus on immune checkpoint inhibitors (ICIs), specifically those targeting PD-1 and CTLA-4, both of which have demonstrated long-term clinical benefits in patients with advanced melanoma. Emerging checkpoint molecules, including LAG-3, TIGIT, and TIM-3, are also described as potential targets for next-generation immunotherapeutic approaches. In addition, this review discusses recent progress in targeted treatment approaches, immune-based therapeutic development, and adoptive cellular immunotherapy. Future studies will likely concentrate on refining combination therapies while developing more personalized treatment strategies that can further improve patient outcomes in melanoma management.