OBJECTIVES: Treatment for metastatic melanoma (mM) has evolved rapidly with the recent approval and reimbursement of new therapies. At the end of 2013, four new therapies, vemurafenib, ipilimumab, drabrafenib and trametinib were available for treatment of specific groups of patients with metastatic melanoma.  Our objective is to compare the drug treatment sequences at centers in Canada during the time periods prior to and after availability of the new therapies.  METHODS: The study used ONCO-CAPPS, a proprietary database of patient chart abstractions collected through regular survey of physician panels.  The data includes demographic details as well as disease markers, and a summary of the patients’ cancer treatments from the time of diagnosis.  Data from the time periods 2007 and 2013 were used to identify patients with metastatic melanoma and document their sequence of treatments.  Conventional treatments include the older therapies: dacarbazine (DTIC), carboplatin-paclitaxel, lomustine, interferon and interleukin-2.   RESULTS: In 2007, 53 patients with mM were treated in first-line (1^st) line and the majority received a conventional therapy. Twenty-one of these patients progressed and received second-line (2^nd) line therapy; 62% of them received a conventional therapy while 38% received an investigational agent.  In 2013, 157 patients with mM were treated in 1^stline; 47%, 10% and 43% of these received a conventional therapy, an investigational agent and a new therapy, respectively.  Of those who progressed, 18%, 11% and 71% received a conventional therapy, an investigational agent and a new therapy, respectively. CONCLUSIONS: With the availability of newer options, a greater proportion of patients are being treated with these agents.  The proportion of patients being treated with an investigational agent in 2^nd line has decreased.  Older agents continue to be used and the use of the newer therapies is dependent on patient characteristics and reimbursement guidelines.