CTLA4 and melanoma: In general, PD-1 inhibitor with or without CTLA-4 inhibitor is the recommended first-line regimen regardless of BRAF variant status.41,42 The physicians' decisions might have been influenced by the results of a Japanese retrospective study, suggesting inferior ICI efficacy in Asians with advanced melanoma.43 However, it remains to be elucidated in future prospective clinical trials whether immunotherapy or targeted therapy is more suitable for advanced Asian melanoma with BRAF V600E/K.