Melanoma is an aggressive neoplasia arising from the malignant transformation of melanocytes. 1 Indian clinical practice, melanoma is frequently diagnosed at an advanced stage, with ~40–44% of patients presenting with metastatic disease at baseline. 1,2 Although programmed cell death ligand-1 (PD-1) inhibitors have significantly improved outcomes, a substantial proportion of patients exhibit resistance, thereby limiting long-term disease control.
3 Upregulation of alternative immune checkpoints, particularly lymphocyte activation gene-3 (LAG-3) , plays a critical role in T-cell exhaustion and adaptive resistance to PD-1 blockade. Dual inhibition of PD-1 and LAG-3 has demonstrated synergistic restoration of T-cell function, enhancing proliferation, cytokine secretion, and cytotoxic activity in preclinical models. 4 The phase 2/3 RELATIVITY-047 trial evaluated nivolumab plus relatlimab…
