Markus Reitmajer, Susanne Dugas-Breit, Chiara L Blomen, Elisabeth Livingstone, Max Schlaak, Markus V Heppt, Michael M Sachse, Madlen Hörold, Friedegund Meier, Sebastian Haferkamp, Christian Apfelbacher, Georgia Schilling, Andrea von den Berg, Frank Meiss, Lisa Zimmer, Andrea Forschner
Robust long-term survival data have transformed the prognosis of metastatic melanoma. For combination therapy with immune checkpoint inhibitors (ICIs), 10-year melanoma-specific survival rates now exceed 50 %, and durable disease control is achievable in a substantial proportion of patients, including those with brain metastases. With increasing long-term survival, chronic and late-onset treatment-related toxicities are becoming increasingly relevant. In particular, chronic immune-related adverse events (irAEs) may persist after discontinuation of ICI therapy or emerge with delayed onset. These toxicities can significantly impair long-term quality of life and often require ongoing management; endocrine toxicities, for example, may necessitate lifelong hormone replacement therapy. In addition to physical sequelae, survivors frequently experience psychosocial and financial burdens, difficulties returning to work, and concerns related to fertility and family planning. These multidimensional challenges highlight the growing importance of survivorship care in patients treated with ICIs. Systematic assessment of physical and psychosocial burden as well as health-related quality of life, especially through patient-reported outcomes, can support clinical decision-making and individualized follow-up strategies. Integrating these assessments into structured, multidisciplinary survivorship care models is essential to address the complex long-term needs of melanoma survivors and to optimize outcomes beyond disease control.