What are the latest Chemos that are working?

Might want to consider TVEC.  It sounds like your mets could be accessed by a needle if they are visible under the skin.  Response rates and side effects are way better than chemo. 

Brad

Why not a PET scan with CT?   My oncologist evaluates melanoma outside my brain with PET/CT scans and uses MRIs to check for melanoma in my brain.   I have had 14 PET scans.

Here is a primer I put together with a review of current melanoma therapies:

https://chaoticallypreciselifeloveandmelanoma.blogspot.com/search?q=primer  

There is a board member in similar need here who is unable to tolerate any further ipi/nivo and here are the responses they were given:  https://www.melanoma.org/find-support/patient-community/mpip-melanoma-patients-information-page/what-next-1   

As I told them, old school chemo is not typically effective in melanoma.  I hope you are seeing a melanoma specialist!!!!  Things have really changed and temodar is not step 2 anymore!!!    

Another possible option is targeted therapy with a BRAF/MEK combo if you are BRAF positive….though I guess given what your doc is saying, you are not.

Another option is the addition of radiation.  We have learned that while radiation alone is not particularly effective in melanoma, when it is combined with immunotherapy the response is better than when either radiation or immunotherapy is used alone.  Here are a zillion articles: 

https://chaoticallypreciselifeloveandmelanoma.blogspot.com/search?q=radiation+and+immunotherapy

While lots of these refer to immunotherapy and radiation used concurrently, given how recently you had immunotherapy, you should still have the potential to reap those benefits.

But, what might be most beneficial for you as you are describing superficial nodules is intralesional therapy.  There are several types.

Here are lots of reports with links within:   https://chaoticallypreciselifeloveandmelanoma.blogspot.com/2018/12/reports-on-intralesionals-for-melanoma.html  

Several folks on this board are currently in treatment with them, and you might check out posts by this guy!

https://www.melanoma.org/find-support/patient-community/mpip-melanoma-patients-information-page/finally-started-blog  

Another option is additional tumor testing.  We have found that when a patient's melanoma tumors do not respond to the standard therapies (like those you have already tried) they may have specific mutations in their tumors that WILL respond to other treatments.  For instance, some patient's tumors have been positive to mutations typically found in breast cancer and once that is discovered and they are treated with the appropriate medicine for that mutation, they respond very well.

Please, please, please make sure you are being seen by a melanoma specialist.  Hope this helps.  I'm sure others will chime in.  celeste

Have you exhaused all your immunotherapy options?

Have you and your oncologist given the ipi + nivo combo and then nivo alone enough time?   I received Yervoy/Opdivo immunotherapy on April 1, June 3, June 24 and July 15, 2016.  I had a PET scan on August 23, 2016.  It was almost 5 months between beginning the combo immunotherapy and receiving my PET scan.  Three or 4 years ago my oncologist told me that chemotherapy does not work for melanoma, but immunotherapy sometimes works.  You might consider receiving Opdivo for 2 months and then evaluate.

Bubbles has given you some great advice and I just wanted to add that I've not seen the term Temodar used here in YEARS. So, it's an old school treatment. Chemo also is not particularly effect at treating melanoma. If your doctor is not a melanoma specialist at a hospital with a department dedicated to melanoma (or pigmented lesions), you may want to get an appointment with one ASAP for a second opinion. 

Jeremy, are you a candidate for a PV-10 trial given that you have cutaneous nodules? It seems like that would be a prime opportunity to try it. As you know, I'm a fan of it!