Advances in clinical immunotherapy of melanoma

Immune therapies are showing remarkable improvements in disease outcomes for both hematologic and oncologic malignancies, the history and progress of which are deeply rooted in melanoma research. Currently, there are six immune-based therapies approved by the United States Food and Drug Administration (FDA) for the treatment of patients with advanced melanoma—more than for any other malignancy—and ongoing research in this field continues to inform therapeutic developments in other cancers. The three broad categories of immune therapy in cancer include non-specific immunomodulation, active immunization, and adoptive cell transfer. Melanoma characteristics that facilitate development of immune-based therapy include ease of tumor sampling, immunogenicity, and high mutational burden. In this review, six case-based scenarios will highlight the utility and clinical advances of immune therapy in advanced cutaneous melanoma. While developments in molecularly targeted therapies are not discussed in detail, there is great interest in combining immune therapies with targeted therapies to improve clinical outcomes, and is currently being addressed in ongoing clinical trials.