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The prospective, multi\u2010site, observational study <jats:styled-content style=\"fixed-case\">IMAGE<\/jats:styled-content> (ipil<jats:styled-content>im<\/jats:styled-content>umab: man<jats:styled-content>age<\/jats:styled-content>ment of advanced melanoma in real practice) included a retrospective cohort to describe real\u2010world treatment prior to approval of the immune checkpoint inhibitor ipilimumab. This retrospective cohort of patients, who started second\u2010line\/subsequent treatment (index therapy) for advanced melanoma within 3\u00a0years before ipilimumab approval, was selected randomly by chart review. Collected data included treatment history, patient outcomes, and healthcare resource utilization. All patients had \u22651\u00a0year of follow\u2010up data. This analysis included 177 patients from Europe (69%) and North America (31%). The most common index therapies (used alone or in combination) were fotemustine (23%), dacarbazine (21%), temozolomide (14%), and platinum\u2010based chemotherapy (14%). Most patients (89%) discontinued index treatment during the study period; the most common reason was disease progression (59%). Among patients with tumor assessment (153\/177; 86%), 2% had complete response, 5% had partial response, and 12% had stable disease on last tumor assessment. At 1\u2010year study follow\u2010up, median progression\u2010free survival was 2.6\u00a0months (95% confidence interval [<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>], 2.1\u20132.9) and median overall survival was 8.8\u00a0months (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 6.5\u20139.7). During follow\u2010up, 95% of the patients had healthcare visits for advanced melanoma, 74% of whom were hospitalized or admitted to a hospice facility. 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