Fast Five Quiz: Metastatic Melanoma

Adil Daud, MD


March 15, 2023

Based on the results of the DreamSeq study, the combination of ipilimumab and nivolumab is most appropriate as first-line treatment in the majority of BRAF mutant–positive patients with newly metastatic disease. This study demonstrated improved overall survival with the combination of ipilimumab and nivolumab vs a BRAF-MEK therapy.

According to the NCCN guidelines, ipilimumab as a single agent is not recommended as first-line therapy. Two clinical trials have demonstrated the superiority nivolumab-ipilimumab combination therapy compared with ipilimumab monotherapy in patients with BRAF-mutant disease. Combination therapy has also been shown to improve progression-free survival compared with single-agent nivolumab.

Although pembrolizumab has been shown to be effective in this setting, combination therapy is generally preferred, as per the NCCN guidelines.

Learn more about the treatment of metastatic melanoma.


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