The incidence of melanoma is increasing steadily both in Poland and worldwide. 
Until 2010 three drugs were approved for the treatment of metastatic melanoma - 
dacarbazine (DTIC) in Europe and USA, fotemustine in Europe and interleukin-2 
(IL-2) in USA. Approval of ipilimumab and vemurafenib in Europe and USA has 
changed the standard of care, while the next candidates such as dabrafenib and 
trametinib have improved survival in phase III studies in metastatic melanoma 
patients. An encouraging treatment strategy is the combination of dabrafenib and 
trametinib, evaluated in a phase I/II study with an ongoing phase III trial. 
Another promising new immune modulating monoclonal antibody (mAb) is anti-PD1 
(BMS-936558), tested in an early phase trial in monotherapy or in combination 
with a multipeptide vaccine in metastatic melanoma patients. Ipilimumab or BRAF 
inhibitors (vemurafenib, dabrafenib) seem to be active in patients with brain 
metastases. Intensive research of melanoma vaccines is currently being carried 
out in a number of countries worldwide. However, no vaccine in the treatment of 
melanoma has been approved by regulatory authorities so far. Lack of effective 
therapy in patients with high-risk resected melanoma led to a number of clinical 
studies of adjuvant treatment. Interferon-α (INF-α) therapy in this setting is 
still controversial. A dendritic cell-based vaccine in a randomized phase II 
trial showed a survival benefit over the control group in patients with 
high-risk resected melanoma. Promising results of long-term survival of advanced 
resected melanoma patients in a phase II study evaluating the genetically 
modified tumour vaccine (GMTV) AGI-101 were reported. This review provides an 
update on clinical strategies used or tested in patients with metastatic 
melanoma.