Supplemental Material for: Complete Response to Neoadjuvant Ipilimumab-Nivolumab in Mucosal Melanoma: Two Case Reports

The second patient presented with multifocal urethral MM with satellite lesions in the vagina and achieved complete clinical response following four cycles of ipilimumab and nivolumab, with no residual melanoma identified on multiple biopsies of the urethral and vaginal mucosa. Given the anticipated morbidity associated with radical surgery, definitive resection was omitted, and the patient continued maintenance nivolumab for 18 months, which was discontinued following the development of bullous pemphigoid.

The patient remained in complete response at the most recent follow-up, 23 months after documented complete response.</p><p dir="ltr">Conclusion</p><p dir="ltr">These cases highlight the potential of neoadjuvant combination immunotherapy as a promising perioperative strategy for localized MM, capable of inducing deep and durable responses and long-term benefits. They also support the need for prospective studies to better define the role of neoadjuvant immunotherapy and identify predictive biomarkers to select patients most likely to benefit in this therapeutically challenging disease.</p>