As a leading expert in the field of metastatic melanoma, Lars Bastholt runs through the recent developments that have transformed treatment of this disease and vastly improved average prognosis. He covers the major trials of drugs targeting the activated MAPK pathway and those blocking CTLA4 and PD1. There is information on which toxicities to look out for with particular regimens, as well as useful guidance on selecting the most appropriate treatment according to patient factors such as disease aggressiveness and molecular biomarkers. Finally, Professor Bastholt looks to trials in progress and how treatment may change in the near future.