by what way physician can enhance outcomes in patients with metastatic malignant melanoma

introduction: the incidence of malignant melanoma is increasing at a rate greater than any other human cancer. although melanoma accounts for only 4 percent of all dermatologic cancers, it is responsible for 80 percent of deaths from skin cancer; only 14 percent of patients with metastatic melanoma survive for five years. the optimal therapy varies with the stage of the disease. surgical excision is the treatment of choice for early disease, while some patients who are at high risk for developing metastatic disease (particularly those with stage ii and iii cancers may benefit from adjuvant therapy with interferon alfa (ifna).(1) the management of patients with disseminated disease is a difficult problem. in carefully selected patients, excision of limited distant metastases can occasionally produce durable benefit. however, most patients with stage iv disease require systemic treatment. traditional systemic treatment approaches include cytotoxic chemotherapy and immunotherapy. several novel therapeutic approaches are under study, the most promising of which target specific molecular abnormalities that have been identified in melanomas. molecularly targeted therapy for advanced melanoma will be reviewed here.(2)