On behalf of the Society for Immunotherapy of Cancer (SITC) and the SITC Melanoma Guideline Expert Panel, we are pleased to announce the publication of SITC’s Melanoma Clinical Practice Guideline (CPG), version 3.0. This manuscript is SITC’s first CPG covering immunotherapy indications for cutaneous melanoma as well as rarer subtypes of the disease.
Immunotherapy is a standard of care option for both BRAF-wildtype and BRAFV600-mutated melanoma. Exciting new data are carving out indications for adjuvant immune checkpoint inhibitor (ICI) therapy for resected stage IIB and IIC disease, neoadjuvant followed by adjuvant ICI therapy for resectable stage IIIB through IV disease, ICI therapy in the frontline for unresectable/metastatic BRAFV600-mutated melanoma, combination ICI plus LAG-3 inhibitor therapy for previously-untreated unresectable/metastatic disease, and the bispecific gp100 peptide-HLA-directed CD3 T-cell engager tebentafusp-tebn for HLA-A*02:01-positive patients with unresectable/metastatic uveal melanoma. Furthermore, long term data reported from earlier trials of immunotherapy have demonstrated a very real possibility of cure for advanced melanoma with ICI therapy.
The sequencing, combination, and duration of immunotherapy used to treat melanoma is highly nuanced, particularly given the paucity of useful biomarkers available to guide decision-making for cutaneous melanoma. The Melanoma Immunotherapy Guideline Expert Panel was formed to generate evidence- and consensus-based recommendations to help clinicians select the appropriate immunotherapeutic regimens based on careful consideration of disease and patient characteristics. The guideline also includes a discussion of intratumoral immunotherapy, response monitoring, special patient populations, treatment of rare melanoma subtypes, and patient education and quality of life. This manuscript, the latest in the ongoing series of SITC Cancer Immunotherapy Guidelines, is available in the Journal for ImmunoTherapy of Cancer (JITC), SITC’s open access, peer-reviewed online journal and will also be available in SITC’s CPG Mobile App.