Ipilimumab Before BRAF Inhibitor Treatment May Be More Beneficial Than Vice Versa for the Majority of Patients With Advanced Melanoma

The use of sequential therapy with ipilimumab and vemurafenib reported by Ackerman et al in this issue demonstrates that patients who failed BRAF inhibitor therapy appeared to have an inferior outcome than patients who received ipilimumab followed by BRAF inhibitor therapy. These results are in line with previous experience and provide additional evidence to support the use of ipilimumab before a BRAF inhibitor in the majority of patients with advanced melanoma who have an activating BRAF mutation and who are treated outside of a clinical trial.