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From dismal prognosis to rising star: melanoma leads the way with new generation cancer therapies

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Attention has now turned to combining new therapies to maximise their value

For decades, the 1-year overall survival for patients with advanced-stage or metastatic melanoma (stage IIIC unresectable or stage IV melanoma) was 30%–35%.1 It is now greater than 70%–80% in clinical trials of targeted and immune drug therapies (Box).210

This is good news for a cancer that continues to rise in incidence around the world and disproportionately affects the young. In Australia, melanoma is the fourth most common cancer and accounts for 10.1% of all new cases and 3.2% of cancer deaths.11 It is also the most common cancer in men aged 25 to 49 years, and women aged 15 to 24 years in New South Wales.12

Although incidence continues to rise in both sexes, mortality and 5-year survival remain stable,11 and the benefits observed with drug therapies in advanced-stage disease are yet to be reflected in population statistics. Most melanomas are cured with surgical excision: efforts are now focused on trialling novel active targeted and immune drug therapies in the 10%–15% of patients with early-stage melanoma that is predicted to recur and cause death.