Combined Nivolumab and Ipilimumab or Monotherapy in Untreated Melanoma

To the Editor: I found the results of the CheckMate 067 study reported by Larkin and colleagues (July 2 issue) 1 to be extremely encouraging. Like many readers, I believe that these findings will rapidly evolve into a new standard of care and a change in daily practice. However, the high proportion of patients in the nivolumab-plus-ipilimumab group who had severe grade 3 or 4 adverse events is undeniably worrisome. In addition, the rate of death was reported to be 3% in the preceding randomized, phase 2 CheckMate 069 clinical trial in which the same combination was used. 2 Many years ago, . . .