Update on immune therapy in melanoma

Introduction: Melanoma is the 6th most common cancer in the United States and advanced disease has traditionally been associated with a poor prognosis. Historical therapies had suboptimal activity, including cytotoxic agents and cytokine therapies. However, since 2011, novel targeted therapies and immune checkpoint inhibitors have greatly improved outcomes in this challenging disease.Areas covered: This article reviews the evolving landscape of advanced melanoma therapeutics, focusing on recent immune therapy advances. We will review clinical data from the last 1-2years with anti-CTLA-4, anti-PD-1/PDL-1, oncolytic viruses and novel combination approaches. We will discuss landmark clinical trials that led to the integration of these agents into clinical management paradigms. We will also briefly cover the search to identify accurate biomarkers of response to these therapies. Finally, we discuss future directions of clinical research with combination immune therapy strategies.Expert opinion: Immune checkpoint inhibitors and other immune therapy strategies have redefined melanoma treatment paradigms. A growing number of patients experience durable responses to these agents. Anti-PD-1 directed agents, in particular, provide significant and sustained benefits for a large number of responding patients. Determining the most effective and least toxic combination approaches, and identifying biomarkers of treatment benefit will be key future objectives.