Dermatological Complications of Systemic Therapies for Melanoma

Modern melanoma therapies, such as targeted therapy (TT) and immunotherapy (IT), proved to significantly prolong progression free and overall survival in patients with advanced melanoma. Since their approval for metastatic disease, these drugs have also been tested and met with success in the adjuvant setting. As the list of indications for systemic melanoma therapies expands, increasing numbers of patients are exposed to systemic therapies and placed at risk of developing adverse events. The skin is the organ that is most commonly affected by modern melanoma therapies. Cutaneous adverse events occur in over 95% of patients treated with BRAF inhibitors, over 90% of those treated with MEK inhibitors, and less frequently in patients undergoing combination therapy. With immune checkpointbased immunotherapy the incidence rates vary between 43.5% and 58.7% with anti- TLA-4 antibodies, 37.4–41.9% in thosereceiving anti-PD-1, and up to 70% in those receiving combination immunotherapy.is dermatologic adverse events can causesignificant morbidity, patient education, prophylaxis, timely recognition, and early intervention of adverse events are crucial in management of patients receiving modern systemic therapies.