Treatment of Stage III Melanoma That Cannot Be Removed By Surgery, Stage IV Melanoma, and Recurrent Melanoma

For information about the treatments listed below, see the Treatment Option Overview section.

Treatment of stage III melanoma that cannot be removed by surgery, stage IV melanoma, and recurrent melanoma may include the following:

• Oncolytic virus therapy (talimogene laherparepvec) injected into the tumor.
• Immunotherapy with ipilimumab, pembrolizumab, nivolumab, or interleukin-2 (IL-2). Sometimes ipilimumab and nivolumab are given together.
• Targeted therapy with signal transduction inhibitors (dabrafenib, trametinib, vemurafenib, cobimetinib, encorafenib, binimetinib). These may be given alone or in combination.
• Chemotherapy.
• Palliative therapy to relieve symptoms and improve the quality of life. This may include:
  • Surgery to remove lymph nodes or tumors in the lung, gastrointestinal (GI) tract, bone, or brain.
  • Radiation therapy to the brain, spinal cord, or bone.

Treatments that are being studied in clinical trials for stage III melanoma that cannot be removed by surgery, stage IV melanoma, and recurrent melanoma include the following:

• Immunotherapy alone or in combination with other therapies such as targeted therapy.
• For melanoma that has spread to the brain, immunotherapy with nivolumab plus ipilimumab.
• Targeted therapy, such as signal transduction inhibitors, angiogenesis inhibitors, oncolytic virus therapy, or drugs that target certain gene mutations. These may be given alone or in combination.
• Surgery to remove all known cancer.
• Regional chemotherapy (hyperthermic isolated limb perfusion). Some patients may also have immunotherapy with tumor necrosis factor.
• Systemic chemotherapy.

Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available.