Currently, skin cancer is one of the most frequent type of cancers. Melanoma is much less common than basal cell and squamous cell skin cancers, but it is far more dangerous. Melanomas represent 3% of all skin cancers but 65% of skin cancer deaths. Detailed knowledge of melanoma at the molecular level allows the development of new treatment alternatives and to design effective new drugs. There are two approaches in therapy of melanoma in the present is based on immunotherapy and targeted therapy or their combination. Immunotherapy includes immune checkpoint blockades whereas targeted therapy is represented by protein kinase inhibitors. Detailed knowledge of protein structure and the understanding of their role in key signalling pathways in melanoma development lead to the designation of new protein kinase inhibitors in targeted therapy. In the future, it is necessary to conduct further clinical trials and collect more data about overall survival, response rates, appropriate timing and sequence of combination therapy to manage the complexity of melanoma treatment.

This chapter presents an overview of possibilities for the therapy of melanoma, current knowledge and future direction. Skin cancer is one of the most frequent types of cancers. Melanoma is much less common than basal cell and squamous cell skin cancers, but it is far more dangerous. Detailed knowledge of melanoma at the molecular level allows to develop new treatment alternatives and to design effective new drugs. There are two approaches in therapy of melanoma in the present based on immunotherapy and targeted therapy or their combination. Immunotherapy includes immune checkpoint blockades, whereas targeted therapy is represented by protein kinase inhibitors, such as BRAF inhibitors, MEK inhibitors, and NRAS inhibitors. Detailed knowledge of protein structure and the understanding of its role in key signaling pathways in melanoma development lead to the designation of new protein kinase inhibitors in targeted therapy.The incidence of melanoma is increasing at one of the highest rates of any form of cancer in fair-skinned populations around the world. The exposure to sunlight during the past 50 years is an important factor for the increasing incidence of melanoma. Mortality rates of melanoma show stabilization in Australia, in North America, and also in European countries. Prevention campaigns aim on reducing incidence and achieving earlier diagnosis, which resulted in an ongoing trend toward thin melanoma since the last two decades. However, the impact of primary prevention measures on incidence rates of melanoma is unlikely to be seen in the near future; rather, increasing incidence rates to 40-50/100,000 inhabitants/year should be expected in Europe in the next decades [15]. The possible signs and symptoms of melanomaThe possible signs and symptoms of melanoma are new moles or spots on the surface of skin that are changing in size, shape and color. Another important sign is a spot that looks different from all of the other spots on skin. There are the ABCDE criteria for these signs, which guide to the usual signs of melanoma:A -Asymmetry; one half of a nevi or birthmark does not match the other.B -Border; the edges are irregular, jagged, or blurred.C -Color; the color is not the same all over and may include shades of brown or black, or sometimes with patches of pink, red, white, or blue. D -Diameter; the spot is larger than 6 mm across, although melanomas can sometimes be smaller than this. E -Evolving; the nevi are changing in size, shape, or color. Melanoma classification and stagingThe classification schemes Breslow's thickness (depth) and Clark's level have been developed based on either the vertical thickness of the lesion in millimeters or the anatomic level of invasion of the layers of skin. Breslow's depth is considered significant factor in predicting the progression of the melanoma. Increased tumor thickness is correlated with metastasis and poorer prognosis. Tumors are classified into four categories based on the depth: thickness of 0.75 mm or less, thickness of 0.76-1.5 mm, thickness of 1.51-4 mm...

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