A 38-year-old male presented with intermittent abdominal pain and was diagnosed with BRAF V600D mutant primary mucosal melanoma of the small bowel….After further progression, he began temozolomide (200 mg/m2, 5 of 28 days), while continuing nivolumab. After 5 cycles of temozolomide with nivolumab, CT showed a partial response with a 71% decrease in the pelvic mass (Fig. 2). The patient has been tolerating the treatment well after 6 months and additional 15% tumor shrinkage (−86% by RECIST).