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Cutaneous melanoma

Nature Reviews Disease Primers volume 11, Article number: 23 (2025) Cite this article

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Abstract

Cutaneous melanoma is a common cancer in Australia and New Zealand, Europe, and North America, and its incidence is still increasing in many regions. Ultraviolet (UV) radiation exposure (for example, through excessive sunlight exposure) remains the primary risk factor for melanoma; however, public awareness campaigns have led to a marked reduction in mortality. In addition to genetic damage from UV radiation, specific genetic alterations have been linked to melanoma. The stage of the tumour at the time of diagnosis is of greater importance for melanoma prognosis than in almost any other cancer. Context-dependent genetic mutations that attenuate tumour-suppressive mechanisms or activate growth-promoting signalling pathways are crucial factors in the development of cutaneous melanoma. In addition to external factors such as UV radiation, the tumour microenvironment can contribute to melanoma progression, invasion and metastasis. Cutaneous melanoma treatment has improved considerably over the past decade with the discovery and development of immune checkpoint inhibitors and therapy targeting BRAF and MEK. Over the next decade, several priorities are likely to influence melanoma research and management, including the continued advance of precision medicine methods to identify the most suitable patients for the most effective treatment, with the aim of improving clinical outcomes.

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Fig. 1: Disease progression in melanoma.
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Fig. 2: Global epidemiology of melanoma.
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Fig. 3: Molecular mechanisms in melanoma pathogenesis.
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Fig. 4: The role of the TME in melanoma.
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Fig. 5: Clinical and dermoscopic images of primary cutaneous melanomas.
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Fig. 6: Clinical and dermoscopic images of primary cutaneous melanomas in patients with darker skin tones.
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Fig. 7: Digital monitoring of melanoma.
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Acknowledgements

The authors thank C. Carrera, K. Liopiris, J. Malvehy and P. Zaballos (all from Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain) for providing the images in Figs. 5, 6 and 7 for this article. The authors extend their sincere gratitude to the patients who provided consent to publish their images in this Primer. A.T. acknowledges the support of an Emmy Noether Award from the German Research Foundation (DFG, 467788900) and the Ministry of Culture and Science of the State of North Rhine-Westphalia (NRW-Nachwuchsgruppenprogramm). A.T. acknowledges the support of an ERC starting grant (METATARGET, 101078355). A.T. holds the Peter Hans Hofschneider endowed Professorship of Molecular Medicine from the Stiftung Experimentelle Biomedizin.

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Authors and Affiliations

  1. Department of Dermatology, University Hospital Essen & German Cancer Consortium (DKTK), Partner Site Essen, Essen, Germany

    Alpaslan Tasdogan & Dirk Schadendorf

  2. National Center for Tumour diseases (NCT-West), Campus Essen & Research Alliance Ruhr, Research Center One Health, University Duisburg-Essen, Essen, Germany

    Alpaslan Tasdogan & Dirk Schadendorf

  3. Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA

    Ryan J. Sullivan

  4. Institute for Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany

    Alexander Katalinic

  5. Université Paris Cite, AP-HP Dermato-oncology and CIC, Cancer institute APHP.nord Paris cité, INSERM U976, Saint Louis Hospital, Paris, France

    Celeste Lebbe

  6. Melanoma Advisory Board South Africa, Cape Town, South Africa

    Dagmar Whitaker

  7. Dermatology Department, IDIBAPS, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain

    Susana Puig

  8. 8CIBERER, Instituto de Salud Carlos III, Barcelona, Spain

    Susana Puig

  9. Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, Netherlands

    Lonneke V. van de Poll-Franse

  10. Department of Medical and Clinical Psychology, CoRPS - Center of Research on Psychology in Somatic Diseases, Tilburg University, Tilburg, Netherlands

    Lonneke V. van de Poll-Franse

  11. Section of Pathology, Department of Health Sciences, University of Florence, Florence, Italy

    Daniela Massi

  12. Department of Molecular Pathobiology, New York University - College of Dentistry, New York, NY, USA

    Daniela Massi

Authors
  1. Alpaslan Tasdogan
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Contributions

Introduction (A.T. and D.S.); Epidemiology (A.K.); Mechanisms/pathophysiology (R.J.S. and D.M.); Diagnosis, screening and prevention (S.P. and D.M.); Management (R.J.S., C.L. and D.W.); Quality of life (L.V.v.d.P.-F.); Outlook (A.T. and D.S.); overview of the Primer (A.T.).

Corresponding authors

Correspondence to Alpaslan Tasdogan or Dirk Schadendorf.

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Competing interests

A.T. declares speakers’ honoraria from Merck Sharp & Dohme. R.J.S. declares personal fees from Marengo, Merck, Novartis, Pfizer and Replimune for consulting/advisory board activity, and research grant support to his institution from Merck. C.L. declares conflicts of interest with BMS, Pierre Fabre, Sanofi, Novartis, MSD, Amgen, Merck Serono, Roche, Inflax and Pfizer. S.P. declares research grants from Almirall, Pfizer, Regeneron, Sanofi, La Roche Posay Philogen, ISDIN and International School of Derma; consulting fees from Sanofi, Regeneron, ISDIN, L’Oreal, La Roche Posay and International School of Derma; personal fees from Sanofi, Sunpharma, Cantabria, Eucerin, ISDIN, L’Oreal, La Roche Posay, Almirall, Avene and Pierre Fabre; and support for attending meetings and/or travel from Almirall, Cantabria and ISDIN. D.M. declares personal fees from Novartis, Sun Pharma, Bayer HealthCare Pharmaceuticals Inc., Pierre-Fabre Oncology, Sanofi Genzyme, MSD Italia S.r.l., Roche and Skyline Dx B.V, and Sakura; and a grant from Regeneron. D.S. reports personal fees and non-financial support from Roche/Genentech, Merck Serono, Sanofi/Regeneron, SunPharma, Neracare, Replimune, Helsinn, OncoSec and InFlaRx; grants, personal fees and non-financial support from Amgen and Novartis; grants, personal fees, non-financial and other support from BMS; and personal fees from Merck Sharp & Dohme, Immunocore, Incyte, 4SC, Pierre Fabre, Array BioPharma, Pfizer, Philogen, Regeneron, Nektar and Sandoz; outside the submitted work. A.K., D.W. and L.V.v.d.P.-F. declare no competing interests.

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Nature Reviews Disease Primers thanks R. Dummer, H. Gogas, E. Novis, M. Postow, R. Saw and the other, anonymous, reviewer(s) for their contribution to the peer review of this work.

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Tasdogan, A., Sullivan, R.J., Katalinic, A. et al. Cutaneous melanoma. Nat Rev Dis Primers 11, 23 (2025). https://doi.org/10.1038/s41572-025-00603-8

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