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Review
. 2025 Jul;34(3):359-374.
doi: 10.1016/j.soc.2025.01.003. Epub 2025 Feb 27.

Systemic Therapy for Melanoma: What Surgeons Need to Know

Ashlee N Seldomridge  1 , Roi Weiser  1 , Ashley M Holder  2
Affiliations
Review

Systemic Therapy for Melanoma: What Surgeons Need to Know

Ashlee N Seldomridge et al. Surg Oncol Clin N Am. 2025 Jul.

Abstract

Immune checkpoint inhibitors and targeted therapies (BRAF/MEK inhibitors) have transformed the care of patients with stage IV melanoma, now with 5-year overall survival rates around 50%. Surgeons should be acquainted with these drugs, the multidisciplinary considerations of their use, and the unique immune-related adverse events (irAEs) they can cause. In this review, we discuss systemic therapies for cutaneous melanoma, including the biology of immune checkpoint inhibition, treatment indications, and toxicities. We also explain how these irAEs and other toxicities can impact surgical planning and perioperative management.

Keywords: Immune checkpoint inhibitors; Immune-related adverse events; Ipilimumab; Melanoma; Nivolumab; Pembrolizumab; Relatlimab; Talimogene laherparepvec.

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Conflict of interest statement

Disclosures Funding Support: A.M. Holder has support provided by the American College of Surgeons Clowes Award, NCI Multi-PI R01, and the Department of Defense CDMRP through the Melanoma Academy Scholar Program. A.N. Seldomridge has support provided by the National Institutes of Health, United States T32 CA 009599 and the MD Anderson Cancer Center, United States support grant (P30 CA016672). R. Weiser has support provided by the SWOG/Hope Foundation Impact Award.

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