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NEW YORK — Not all patients with melanoma should receive combination checkpoint inhibition with ipilimumab and nivolumab, Jeffrey S. Weber, MD, PhD, said in a debate at HemOnc Today Melanoma and Cutaneous Malignancies.

Weber cautioned that ipilimumab (Yervoy, Bristol Meyers Squibb) and nivolumab (Opdivo, Bristol Meyers Squibb) combination therapy can be relatively toxic. In addition, he suggested that patients with BRAF mutations, low-disease burden and normal lactate dehydrogenase, as well as those with hot tumors, may achieve comparable outcomes with other therapies.

 “I think we all agree if you have a ‘cold tumor’ or a high disease burden, it would make all the sense in the world to treat patients with ipilimumab and nivolumab” Weber told HemOnc Today. “My position is not that you shouldn’t be treating with the combination, my position is you have to be judicious in choosing whom to treat with that combination.”