For more information from the National Cancer Institute about melanoma, see the following:Melanoma Home PageWhat You Need to Know About™ Melanoma and Other Skin CancersSkin Cancer PreventionSkin Cancer ScreeningSentinel Lymph Node BiopsyDrugs Approved for MelanomaBiological Therapies for CancerUnderstanding Cancer Series: Targeted Therapies (Advances in Targeted Therapies)Targeted Cancer TherapiesFor general cancer information and other resources from the National Cancer Institute, see the following:What You Need to Know About™ CancerUnderstanding Cancer Series: CancerCancer StagingChemotherapy and You: Support for People With CancerRadiation Therapy and You: Support for People With CancerCoping with Cancer: Supportive and Palliative CareQuestions to Ask Your Doctor About CancerCancer LibraryInformation For Survivors/Caregivers/Advocates
Stage IV melanoma is defined by the American Joint Committee on Cancer's TNM classification system:Any T, any N, M1Treatment Options for Patients With Stage IV and Recurrent MelanomaImmunotherapy.Checkpoint inhibitors.Interleukin-2 (IL-2).Signal transduction inhibitors.BRAF (V-raf murine sarcoma viral oncogene homolog B1) inhibitors (for patients who test positive for the BRAF V600 mutation).MEK inhibitors.Multikinase inhibitors.KIT inhibitors.Chemotherapy.Palliative local therapy.Clinical trials should be strongly considered because of the rapid advances in the development of novel agents and combinations of agents designed to reverse or interrupt aberrant molecular pathways that support tumor growth.Treatment option overview for patients with stage IV and recurrent melanomaAlthough melanoma that has spread to distant sites is rarely curable, two approaches have demonstrated clinical benefit by prolonging overall survival (OS) in randomized trials:
Extrascleral extension confers a poor prognosis. For patients with gross tumor involvement of the orbit, treatment requires orbital exenteration. However, there is no evidence that such radical surgery will prolong life. Most patients with localized or encapsulated extraocular extension are not exenterated. This subject is controversial.[1,2,3,4,5]No effective method of systemic treatment has been identified for patients with metastatic ocular melanoma. Available clinical trials should be considered as an option for these patients.Current Clinical TrialsCheck for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with extraocular extension melanoma and metastatic intraocular melanoma. The list of clinical trials can be further narrowed by location, drug, intervention, and other criteria.General information about clinical trials is also available from the NCI Web site.References: Shammas HF, Blodi FC: Prognostic factors in choroidal and
Is this topic for you? This topic is about nonmelanoma skin cancer, including basal cell cancer and squamous cell cancer. For information about melanoma skin cancer, see the topic Skin Cancer, Melanoma.
Radiation therapy for nonmelanoma skin cancer may be recommended for people who may not be able to have surgery because of the location of the skin cancer. Radiation therapy may also be a treatment choice for older adults if surgery is too risky.