CTLA4 and melanoma: This association was very good in the patients treated with monotherapy, but not in the patients treated with a dual ICI combination [15]. CheckMate 066 and 067 phase III clinical trials evaluating ICIs revealed that patients receiving the anti-PD-1 inhibitor NIVO alone or in combination with the anti-CTLA-4 inhibitor IPI or IPI alone have a longer survival benefit if the TMB score was high. TMB holds significant promise as a predictive biomarker for ICI response in melanoma, offering a pathway to more personalized and effective immunotherapy [16,17].