Prognosis for advanced and metastatic melanoma is poor, with a 5-year survival 
of 78, 59 and 40% for patients with stage IIIA, IIIB and IIIC, respectively, and 
a 1-year survival of 62% for M1a, 53% for M1b and 33% for M1c. The 
unsatisfactory results of actual standard therapies for metastatic melanoma 
highlight the need for effective new therapeutic strategies. Several drugs, 
including BRAF, KIT and MEK inhibitors, are currently being evaluated after 
promising data from Phase I and Phase II studies; Vemurafenib, a BRAF-inhibitor 
agent, has been approved by the Food and Drug Administration (FDA) for the 
treatment of patients with unresectable or metastatic melanoma with the BRAF 
V600E mutation after a significant impact on both progression-free and overall 
survival was demonstrated compared with dacarbazine in a Phase III trial. 
Ipilimumab, an immunotherapeutic drug, has proven to be capable of inducing 
long-lasting responses and was approved for patients with advanced melanoma in 
first- and second-line treatment by the FDA and in second-line treatment by the 
European Medicines Agency. Furthermore, a significant survival benefit of the 
combination of ipilimumab with dacarbazine compared with dacarbazine alone for 
first-line treatment was reported. In the near future, patients with BRAF 
mutations could have the chance to benefit from treatment with BRAF inhibitors; 
patients harboring BRAF or NRAS mutations could be treated with MEK inhibitors; 
finally, the subgroup of patients with acral, mucosal or chronic sun-damaged 
melanoma harboring a KIT mutation could benefit from KIT inhibitors. Ipilimumab 
could become a standard treatment for metastatic melanoma, both as a single 
agent and in combination; its efficacy has been proven, and researchers should 
now address their efforts to understanding the predictive variables of response 
to treatment.