Abstract Introduction: Patients with metastatic melanoma who progress on standard of care therapy have limited treatment options. This study evaluates the efficacy of nivolumab combined with temozolomide compared to temozolomide alone in this refractory setting. Methods: We conducted a retrospective cohort study of 44 patients with metastatic melanoma who progressed on prior immunotherapy and systemic therapies. Patients were chemotherapy-naïve and treated at a single center between 2020-2025.
