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Melanoma — SCE Medical Oncology MCQ

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HardMelanoma & SkinMelanomaSCE Medical Oncology

A fit patient with BRAF-wild-type metastatic melanoma has unequivocal progression after combined nivolumab and ipilimumab. Brain imaging is negative. What is the most appropriate general next strategy?

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Correct answer: D — Refer for a clinical trial and specialist review of available later-line options

Progression on combined PD-1 and CTLA-4 blockade makes routine substitution of another PD-1 antibody unlikely to provide meaningful benefit. BRAF/MEK therapy is not applicable to BRAF-wild-type disease. Later-line management should be individualised in a melanoma MDT, with clinical-trial access prioritised and chemotherapy or other licensed options considered according to prior therapy and fitness.

Reference: https://www.nice.org.uk/guidance/conditions-and-diseases/cancer