How would you treat a BRAF WT metastatic melanoma patient with leptomeningeal disease in the frontline setting?  

LMD from melanoma carries a dismal prognosis (weeks to a few months of survival), depending on how symptomatic the patient is from the increased intracranial pressure. Please refer to a case report I published a while ago with Dr. Ahmad Tarhini from Moffitt Cancer Institute for a discussion of this ...

I would start with assessing the patient for symptoms and looking at the molecular profile.If asymptomatic and molecular profile is favorable (TMB high, high PDL-1, etc.), then Ipi-Nivo (as per CheckMate 204) affords the best outcomes.If symptomatic, then this is a scenario with the worst outcome. I...