In what situation would you recommend ipilimumab + nivolumab over relatlimab + nivolumab in the treatment of metastatic melanoma?

There is no clinical trial to provide a direct comparison between the two regimens, hence the answer to this question is usually driven by personal interpretation of the data and patient preference. The data for both regimens show a statistically significant PFS benefit and a superior response rate ...

As stated above, there’s no direct comparison. However, I take these factors into consideration:

• Nivolumab plus Ipilimumab seems especially effective in BRAF-mutated melanoma. HR for PFS compared to Nivolumab alone was 0.59 with BRAF mutation vs 0.89 with wild-type BRAF. HRs for OS were 0.69 and 0.9...

I favor nivo/rela, especially for older patients who may be a bit on the frail side (ECOG 1+). I have tried ipi/nivo in this population (mostly in the anti-PD-1 refractory setting) before nivo/rela was available, and have found most patients couldn’t tolerate past the first two cycles of ipi/nivo. T...

Great question. In general, we know nivo-ipi is the most active, but also the most toxic immunotherapy regimen for melanoma. I save it for "one shot on goal" situations where you sense that you won't have time to sequence checkpoint inhibitors. As mentioned, such situations include brain mets, high ...