In addition, IGF1R was selected as a candidate because previously we found evidence of a correlation between LMD prognosis and IGF1 protein level in CSF.2 Because there are no FDA-approved IGF1R-specific inhibitors that have good blood-brain penetration ability, we decided to use ceritinib, a potent tyrosine kinase inhibitor that has been shown to work synergistically with trametinib (an FDA-approved MEK inhibitor) in preclinical wildtype melanoma models.13,27. This evidence concerns the gene IGF1 and melanoma.