Usefulness of nivolumab plus ipilimumab immunotherapy for metastatic uveal melanoma.

A 53-year-old woman with known localized uveal melanoma presented with pain from a large destructive lesion of the left iliac bone. Biopsy confirmed metastatic melanoma, and positron emission tomography scan showed extensive osseous destruction. Because her uveal melanoma was successfully treated with brachytherapy 15 years earlier, next-generation sequencing was performed, and a GNAQ mutation proved the lesion to be of uveal origin. Uveal melanoma has a worse prognosis than cutaneous melanoma. We initiated treatment with the combination of nivolumab and ipilimumab, and after four cycles of treatment a positron emission tomography scan showed resolution of all prior lesions. The patient was then placed on maintenance therapy.