Melanoma is a growing public health problem, with 59 940 new cases of invasive melanoma and approximately 8110 deaths attributable to melanoma expected in 2007 in the United States according to the American Cancer Society. It can affect both young and old and therefore accounts for a disproportionate number of years of life lost relative to other common cancers. Surgery has always been, and remains, the mainstay of treatment for melanoma and can be quite effective for patients with early disease. Our ability to treat patients with established distant metastases is very limited; systemic chemotherapies, immunotherapies, and combination therapies have demonstrated limited response rates and no overall survival advantage. Moreover, currently described prognostic factors are of limited value, factors predictive of response to therapies are poorly understood, and current diagnostic techniques cannot always make a clear distinction between melanoma and atypical but benign melanocytic lesions. New approaches are sorely needed.
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