First-Line Treatment of Unresectable and/or Metastatic Cutaneous Amelanocytic Melanoma — BRAF Wild-Type

This protocol covers the first-line management of patients with unresectable and/or metastatic cutaneous amelanocytic melanoma in whom tumour testing confirms BRAF wild-type status (no BRAF mutation present).

Clinical Scenario

The patient has unresectable and/or metastatic cutaneous melanoma with confirmed absence of a BRAF mutation. Because BRAF-targeted pathways are not applicable in this setting, a distinct first-line treatment strategy applies.

First-Line Approach

Several intravenous immunotherapy-based regimens are recommended as first-line options in this setting — including both combination and monotherapy approaches.

The complete structured regimen — with specific agents, sequences, and clinical selection criteria — is available in the full protocol below.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1200/JCO.23.01136

For patients with BRAF wild-type, unresectable and/or metastatic cutaneous melanoma, the following treatment options should be offered (in no particular order): nivolumab plus ipilimumab followed by nivolumab OR nivolumab plus relatlimab OR nivolumab OR pembrolizumab.

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