Adjuvant/neo-adjuvant setting. For high-risk, early-stage melanoma, the benefit of adjuvant immunotherapy was underpinned by a seminal study by Eggermont et al. in which the CTLA-4 inhibitor ipilimumab was found to increase the 3-year recurrence free rate by more than 10% ((46·5% (95% CI 41.5–51.3) vs. 34.8% (30.1–39.5)) compared to placebo [46]. This evidence concerns the gene CTLA4 and melanoma.