CTLA4 and melanoma: To build on the numbers of 30 patients of LEAP-004 cohort considered refractory to nivolumab/ipilimumab, we collected here our experience using pembrolizumab/lenvatinib in these heavily pre-treated melanoma patients that relapsed to both anti-PD-1 and anti-CTLA-4 ICIs either in combinatorial or in sequential setting.