Diagnosed with Melanoma during COVID — how has treatment changed

How Melanoma Treatment Has Evolved Since COVID

That's a great question, and it's encouraging that you're thinking about whether newer options might be available to you now. Let me walk you through the significant advances in melanoma treatment that have emerged, particularly in the last few years.

Major Treatment Advances Since 2020

Immunotherapy Expansion The biggest shift has been the growing use of immunotherapy (treatments that help your immune system fight cancer). According to the NCCN Guidelines for Patients: Melanoma (2025), checkpoint inhibitors like pembrolizumab (Keytruda) and nivolumab (Opdivo) are now standard options for many melanoma patients. These drugs work by blocking proteins that cancer cells use to hide from your immune system, essentially "freeing" your T cells (immune cells) to attack the tumor.

What's new: A newer injectable form of nivolumab combined with hyaluronidase-nvhy (Opdivo Qvantig) can now be given under the skin every 2-4 weeks instead of requiring IV infusions every few weeks—making treatment more convenient.

Targeted Therapy Refinement If your melanoma has a BRAF V600 mutation (a specific genetic change), targeted therapies like dabrafenib/trametinib have become more refined and are now used in more treatment settings, including as adjuvant therapy (treatment after surgery to prevent recurrence).

T-VEC (Intralesional Therapy) Talimogene laherparepvec (T-VEC) is an FDA-approved treatment that uses a modified virus to directly attack melanoma cells. According to the NCCN Guidelines, this is now a preferred option for certain types of recurrent melanoma, particularly satellite and in-transit recurrence (cancer that returns near the original site).

Combination Approaches Treatment strategies have become more sophisticated. Rather than using single treatments, doctors now often combine approaches—for example, surgery followed by immunotherapy, or neoadjuvant therapy (treatment before surgery) to shrink tumors first.

What This Means for You

Here are important questions to ask your oncology team:

1. "Have there been any changes to my diagnosis or stage since 2020 that might open up new treatment options?" (Sometimes new testing methods reveal information that wasn't available before)

2. "If I have a BRAF mutation, am I currently on targeted therapy, or would that be appropriate for me now?"

3. "Given current guidelines, would immunotherapy be a good option for my situation, either as adjuvant therapy or if my cancer recurs?"

4. "Are there clinical trials available that might offer newer treatment approaches?" According to the NCCN Guidelines, everyone with cancer should consider clinical trials as part of their treatment options.

5. "Has my treatment plan been updated based on 2024-2025 guidelines?" Guidelines are updated regularly, and your care team may have new recommendations.

Important Context

The American Cancer Society and NCCN Guidelines emphasize that melanoma treatment is highly individualized based on:

• Your cancer's stage and specific characteristics
• Genetic mutations (like BRAF status)
• Whether your cancer has recurred
• Your overall health and preferences

Even if you were treated appropriately in 2020, newer options may now be available or more appropriate for your specific situation—especially if you're dealing with recurrence or if your original treatment didn't work as hoped.

Next Steps

I'd recommend scheduling a comprehensive review with your oncologist to discuss:

• Whether your original pathology report should be re-tested for biomarkers (genetic mutations) using current methods
• How your treatment compares to 2025 NCCN Guidelines recommendations
• Whether you're a candidate for any newer approaches

This information is for educational purposes only. Always consult your healthcare team for personalized medical advice and decisions.