have metastatic melanoma. Final decisions are individualized by an oncologist in general and may depend on the availability. Metastatic disease is inoperable usually

but in certain cases localized and regional metastases can be excised

order to be helpful in eliminating the remaining disease. Immunotherapy with anti-programmed death (PD-1) – antibodies (pembrolizumab and Nivolumab) prolongs survival. They inhibit the PD-1 receptor

attenuates the response of T-cell effector on cancer. Ipilimumab (a monoclonal antibodies against cytotoxic T lymphocyte-associated antigen 4 [CTLA-4]) is another form of immunotherapy

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