This study looks at two treatments for advanced melanoma, a type of skin cancer that has spread and can't be removed by surgery. One treatment includes **VO and nivolumab** (a medicine that helps the immune system fight cancer), and the other is a treatment the patient's doctor chooses. The study is for patients whose cancer worsened after using anti-PD-1 and anti-CTLA-4 medicines, or who can't use anti-CTLA-4 therapy. Participants must be 12 years or older and have a specific cancer stage. They must also have good blood, liver, and kidney health and agree to use effective birth control. People with certain infections or other serious conditions, such as active brain cancer or heart disease, cannot join. This study helps doctors find better ways to treat advanced melanoma.

• Participants will need to attend multiple visits for treatment and monitoring.
• Eligibility requires confirmed cancer progression after previous treatments.
• Some conditions, like recent major surgery or certain infections, disqualify participation.