PURPOSE To provide guidance to clinicians regarding the use of systemic therapy for melanoma. METHODS ASCO convened an Expert Panel and conducted a systematic review of the literature. RESULTS A systematic review, one meta-analysis, and 34 additional randomized trials were identified. The published studies included a wide range of systemic therapies in cutaneous and noncutaneous melanoma. RECOMMENDATIONS In the adjuvant setting, nivolumab or pembrolizumab should be offered to patients with resected stage IIIA/B/C/D BRAF wild-type cutaneous melanoma, while either of those two agents or the combination of dabrafenib and trametinib should be offered in BRAF-mutant disease. No recommendation could be made for or against the use of neoadjuvant therapy in cutaneous melanoma. In the unresectable/metastatic setting, ipilimumab plus nivolumab, nivolumab alone, or pembrolizumab alone should be offered to patients with BRAF wild-type cutaneous melanoma, while those three regimens or combination BRAF/MEK inhibitor therapy with dabrafenib/trametinib, encorafenib/binimetinib, or vemurafenib/cobimetinib should be offered in BRAF-mutant disease. Patients with mucosal melanoma may be offered the same therapies recommended for cutaneous melanoma. No recommendation could be made for or against specific therapy for uveal melanoma. Additional information is available at www.asco.org/melanoma-guidelines.

中文翻译：

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黑色素瘤的全身治疗：ASCO 指南

目的 为临床医生提供关于黑色素瘤全身治疗的指导。方法 ASCO 召集专家小组并对文献进行系统回顾。结果 确定了一项系统评价、一项荟萃分析和 34 项其他随机试验。已发表的研究包括皮肤和非皮肤黑色素瘤的多种全身治疗。建议在辅助治疗中，纳武单抗或派姆单抗应提供给已切除的 IIIA/B/C/D 期 BRAF 野生型皮肤黑色素瘤患者，而这两种药物中的任何一种或达拉非尼和曲美替尼的组合应提供给 BRAF-突变疾病。无法提出支持或反对在皮肤黑色素瘤中使用新辅助治疗的建议。在不可切除/转移的情况下，应向 BRAF 野生型皮肤黑色素瘤患者提供伊匹单抗加纳武单抗、单用纳武单抗或单用派姆单抗，而这三种方案或 BRAF/MEK 抑制剂联合达拉非尼/曲美替尼、恩科拉非尼/比尼美替尼、或 vemurafenib/cobimetinib 应用于 BRAF 突变疾病。粘膜黑色素瘤患者可以接受与皮肤黑色素瘤推荐的相同治疗。无法提出支持或反对葡萄膜黑色素瘤的特定治疗的建议。更多信息请访问 www.asco.org/melanoma-guidelines。