Objective: To estimate general public preference-based utilities for standardized health states that include common responses and toxicities observed during treatment of advanced melanoma. Methods: A cross-sectional study was used to elicit standard gamble utilities for melanoma in the UK and Australia. Health states included partial response (PR), stable disease (SD) and progressive disease (PD). Common grade I/II toxicities (occurring in >10% of patients) were abstracted from the literature for dacarbazine, temozolomide, interleukin-2, fotemustine, and interferon alpha2b. These may also apply for ipilumumab, a developmental immunotherapy. Health state descriptions were based on WHO response definitions, Common Toxicity Criteria for Adverse events v3, and feedback from five clinical experts and three quality-of-life researchers. Results: Utilities were elicited from 110 participants in the UK (n=64) and Australia (n=56). Mean utilities estimated (for UK vs. Australian respondents) were as follows: PR (0.85 vs. 0.89); SD (0.77 vs. 0.80); PD (0.59 vs. 0.44); and best supportive care (0.59 vs. 0.44). Utility decrements associated with the toxicities were: hair loss (-0.03); skin reaction (-0.03 vs. -0.08); diarrhea (-0.06 vs. 0.12); toxicity, but indication that treatment may be working (-0.06 vs. -0.08); nausea/vomiting (-0.07 vs. -0.13); flu-like syndrome (-0.09 vs. -0.13); stomatitis (-0.10 vs. -0.15); 1-day out/inpatient care for grade 3/4 toxicity (-0.11 vs. -0.15); symptomatic melanoma (-0.11 vs. -0.22); and hospitalization for grade 3/4 toxicity (-0.13 vs. -0.22). Conclusion: The development process for these standardized health states for advanced melanoma can serve as a model for developing disease-specific health states that incorporate both intended treatment responses and adverse events. PR and SD are preferred, and symptomatic melanoma and hospitalization for toxicity yield the highest disutilities. The method of decrementing utility values by subtracting toxicity utility weights holds promise for assigning utilities to serious diseases treated with toxic therapies.