Camrelizumab in Combination With Apatinib and Temozolomide as First-line Treatment in Advanced Acral Melanoma

This study is testing a combination of three drugs — camrelizumab (an immunotherapy), apatinib (a drug that cuts off blood supply to tumors), and temozolomide (a chemotherapy) — as a first-line treatment for advanced acral melanoma. Acral melanoma is a rare type of skin cancer that occurs on the palms, soles, or under nails, and is more common in Asian populations. **You may be eligible if...** - You are 18 or older - You have confirmed acral melanoma that has spread or cannot be surgically removed (stage III/IV) - You have not received any prior systemic cancer treatment for this cancer - Your cancer is measurable on scans - Your overall health status is good (ECOG 0–1) and your organs are functioning well - Your life expectancy is more than 12 weeks **You may NOT be eligible if...** - You are currently receiving other chemotherapy, radiation, or immunotherapy - You have had other cancers (except certain treated skin or cervical cancers) - You have active autoimmune disease - You have significant heart problems - You are pregnant or breastfeeding - You received a live vaccine within 4 weeks before enrollment Talk to your doctor to see if this trial is right for you.