Adjuvant treatment for high risk melanoma. Where are we now?

Abstract

The survival rate for stage 3 and 4 melanoma is very poor. In the absence of effective treatments for metastatic disease focus has shifted to the adjuvant setting. While we are now able to identify those who are at high risk of recurrence the role of adjuvant systemic treatment in these individuals is still undefined. This is partly due to the lack of effective treatments, despite the advances in the understanding of the biology of melanoma and the natural history of the disease process. Of the various treatments studied in the adjuvant setting only interferons and vaccines have been shown to affect the clinical outcome but no agent has been accepted as a standard, with differences in practice between the US and Europe. In this review article we will report what is known at this time about the different agents studied in the adjuvant setting and refer to some new areas of research that may play a bigger role in the future management of melanoma.