MELANOMA: FROM EARLY DETECTION TO THERAPEUTIC DECISION-MAKING
MELANOMA: FROM EARLY DETECTION TO THERAPEUTIC DECISION-MAKING

Summary/Abstract: Background: Melanoma ranks among the most aggressive cutaneous malignancies, distinguished by its high metastatic potential and rapidly evolving clinical course. Early detection remains a major challenge, as differentiating pigmented lesions requires substantial clinical expertise, often in combination with advanced imaging modalities. Over the past decade, therapeutic progress has been remarkable, particularly with the advent of molecularly targeted agents and immunotherapy, which have markedly improved survival outcomes in patients with advanced-stage disease. Aim of the Study: This narrative review aims to provide an up-to-date synthesis of diagnostic pathways and systemic treatment strategies in melanoma, with particular emphasis on areas that remain underexplored in the literature, including challenges in early detection, therapeutic selection, and real-world limitations of current interventions. Material and methods: A narrative review methodology was employed, focusing on recent literature addressing diagnostic approaches, systemic therapies, and practical challenges in melanoma management. Relevant studies were identified through a comprehensive search of major medical databases, emphasizing publications reporting clinical outcomes, therapeutic innovations, and real-world treatment limitations. Results: Therapeutic advancements, particularly the introduction of molecularly targeted agents and immunotherapies, have substantially improved survival in patients with advanced melanoma. However, significant challenges persist, including the development of treatment resistance, therapy-associated toxicities, and the limited availability of modern diagnostic and therapeutic resources in many clinical settings. Furthermore, early detection of melanoma remains difficult and requires a combination of clinical expertise and advanced imaging techniques. Conclusions: Despite substantial progress in melanoma management, important gaps remain in early diagnosis, optimal therapeutic selection, and access to modern treatments. Recognizing these challenges provides clinicians with practical insights and guidance to optimize care and improve patient outcomes.

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