Exploring Mechanisms and Promising Treatments of Malignant Melanoma

Malignant melanoma is one of the 4 main types of skin cancer, among basal cell carcinoma, squamous cell carcinoma, and Merkel cell carcinoma, and it is the most aggressive and metastatic form. Unfortunately, advanced-stage, metastatic patients have a 5-year survival rate of a mere 5% to 19%. The traditional first-line treatment option for localized cutaneous melanomas is a tumor and margin excision surgery; however, in advanced-stage patients, chemotherapy drugs and targeted therapies have emerged as a more effective treatment option. The rising incidence of malignant melanoma in the fair-skinned populations of North America, Europe, and Australia, along with rising resistance to immune checkpoint inhibitors (ICIs), underscores the importance of new, efficacious melanoma treatments. The novel and breakthrough development of two types of immunotherapies, T-cell receptor (TCR) engineered T-cell immunotherapy (TCR-T) and mRNA vaccines, are promising treatment options, especially for advanced-stage, metastatic patients. While these treatments are in the early stages of development, various clinical trials have resulted in positive outcomes. Lastly, this review will highlight the challenges and setbacks to immunotherapy and future directions. Immunotherapy may become the standard for melanoma treatment, however, by overcoming current barriers, only time will tell.