Choosing a Preferred Combination Immune Checkpoint Inhibitor (ICI) Regimen and Identifying Patients Appropriate for ICI Monotherapy

Publication date: Jun 26, 2025

One expert expresses a strong preference for nivolumab plus ipilimumab, citing long-term survival data from the CheckMate 067 study, particularly for patients with aggressive or central nervous systeminvolved disease. Additionally, sequential therapy (starting with monotherapy and adding later if needed) could achieve similar outcomes while minimizing toxicity. The conversation closes with consideration of patient-specific factors in choosing monotherapy. One expert also mentions considering BRAF wild-type status as a factor based on earlier subset data suggesting more pronounced benefits from combination therapy in BRAF-mutant patients. All agree that although newer combinations offer promise, they still carry more toxicity than monotherapy, especially in vulnerable populations, and careful patient selection remains key. However, they acknowledge that nivolumab plus relatlimab is an emerging option and may shift practices as more data become available. Some clinicians prefer this approach in older patients or those with limited disease, such as lung-only metastases. In this segment of the OncLive Peer Exchange discussion on metastatic melanoma, panelists dive deeper into their frontline treatment preferences.

Semantics