Prior to the March 25, 2011 FDA-approval of ipilimumab (ipi), clinical trial data indicated that no drug treatment (tx) for advanced melanoma (AM) (unresectable or metastatic melanoma) led to an improvement in overall survival (OS). OBJECTIVES: To further explore the relationship between OS and the treatments available for AM patients prior to ipi approval by examining real world (RM) data. METHODS: Baseline characteristics, tx and outcomes of 752 newly diagnosed AM pts (2004-2008) were collected from the medical charts of a nationally representative random sample of 113 U.S. oncologists. Follow-up of survival outcomes concluded on the date of ipi approval. OS from AM diagnosis to 1 and 2 years were described by stage and by whether pts were incident (no prior melanoma) or recurrent (AM diagnosis after early-stage melanoma). To determine change in outcomes over time, current OS of incident pts was compared to published data on a prior cohort of pts from the AJCC registry, staged at initial melanoma diagnosis (Balch 2001). RESULTS: One-year (39.8%, 95% CI=[34.2-45.3%]) and 2-year (27.6%, 95% CI=[22.4-32.8%]) survival rates among incident Stage IV pts were statistically similar to weighted averages (by metastasis classification) from the AJCC registry. Incident unresectable Stage III pts had lower OS rates than the weighted average of all Stage III pts  from the AJCC registry (which included both resectable and unresectable pts). CONCLUSIONS: These real-world data show that incident metastatic melanoma pts diagnosed from 2004 to 2008 had OS similar to the AJCC registry pts—who were diagnosed in prior decades—and confirm the limitations of AM tx prior to ipi approval. Future research should examine OS in real-world AM pts following ipi approval.