Study on Metronomic Cyclophosphamide and Pembrolizumab for Melanoma Resistant to Checkpoint Inhibitors

Inclusion Criteria

• Must be 18 years or older.
• Have advanced melanoma that cannot be removed by surgery.
• Have measurable cancer as determined by medical scans.
• Be in relatively good health with a performance status score of 0, 1, or 2.
• Have a life expectancy of at least 12 weeks.
• Have adequate bone marrow, liver, and kidney function.
• Meet specific blood test requirements, including hemoglobin, platelet, and neutrophil counts.
• Have recovered from previous pembrolizumab treatment side effects, except for certain hormone-related issues.
• Women of childbearing potential must have a negative pregnancy test before starting treatment.
• Agree to use effective birth control during the study and for a specified time after.
• Men must not donate sperm during the study and for six months after treatment.

Exclusion Criteria

• Have a type of melanoma affecting the eyes or a history of other cancers, with some exceptions.
• Have untreated or symptomatic brain metastases.
• Have had certain treatments within 6-9 weeks before starting the study.
• Have a specific gene mutation without prior treatment unless unable to tolerate it.
• Have certain chronic viral infections unless well-controlled.
• Have abnormal blood test results outside specified ranges.
• Have a history of organ transplant.