CTLA4 and melanoma: Immunotherapy has transformed the treatment of melanoma patients, with monoclonal antibodies blocking the immune regulator programmed cell death protein 1 (PD-1; pembrolizumab and nivolumab) receiving rapid FDA approval following demonstration of a survival benefit compared with chemotherapy and the cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) inhibitor, ipilimumab1–3.