RECENT ADVANCES IN THE CLINICAL MANAGEMENT OF MELANOMA: DIAGNOSIS, BIOMARKERS, AND IMMUNOTHERAPY

Abstract

Melanoma is a malignant neoplasm of melanocytes, characterized by high mortality and early metastatic potential. Although it represents a small fraction of skin cancers, it accounts for the majority of deaths related to these tumors. This narrative review summarized the main recent advances in diagnosis, prognosis, and treatment, while also highlighting remaining gaps. The search was conducted in the PubMed/MEDLINE database, covering publications from 1998 to 2024. Twelve articles were included, including observational studies, clinical trials, systematic reviews, and case reports. The findings highlighted the usefulness of immunohistochemical and molecular markers, as well as PET/CT, in metabolic assessment. Among the biomarkers, melanoma inhibitory activity (MIA), serum LDH, macrophage polarization, and Ki-67 expression stood out, although they have not yet been validated for routine use. In the acral and amelanotic subtypes, diagnostic difficulty remained, often associated with therapeutic delays. In the therapeutic field, the introduction of targeted therapies and immunotherapy with checkpoint inhibitors has transformed the prognosis, although primary and acquired resistance remain a challenge. In summary, significant advances have been achieved, but early detection, biomarker validation, and the development of new therapeutic strategies remain priorities.