Treatment of Melanoma Metastasis: Surgical, Chemotherapy, and Innovation

Melanoma is a form of skin cancer with an increased ability to metastasis to organs such as the brain and other visceral organs, contributing to its aggressiveness and seriousness. Melanoma’s prevalence around the globe rapidly continues to rise. Melanoma development is a complex process often depicted as a step-wise process with the potential to end in metastatic disease. Recent studies suggest that the process could be non-linear. Melanoma has many risk factors including genetics, UV exposure, or exposure to carcinogens. Current treatments for metastatic melanoma include surgery, chemotherapy, and immune checkpoint inhibitors (ICIs); however, each of these treatments comes with limitations, toxicities, and relatively poor outcomes. There are various guidelines set by the American Joint Committee on Cancer guiding surgical treatment options based on the site of metastasis. Surgical treatments cannot fully treat widespread metastatic melanoma but can contribute to better patient outcomes overall. Many chemotherapy options are ineffective against melanoma or come with extreme toxicities; however, alkylating agents, platinum analogs, and microtubular toxins have shown some effectiveness against metastatic melanoma. ICIs are a relatively new treatment option and offer a promising option for patients; however, ICIs are subject to tumor resistance mechanisms and are not effective for every metastatic melanoma patient. Due to the limitations of conventional treatments, there is a need for newer and more effective treatment options for metastatic melanoma. This review aims to highlight the current surgical, chemotherapy, and ICI treatments for metastatic melanoma, as well as current clinical and preclinical investigations to discover revolutionary options for patients.