Treatment patterns and outcomes for patients with advanced melanoma in US oncology clinical practices

Future Oncol. 2019 Feb;15(5):459-471. doi: 10.2217/fon-2018-0620. Epub 2018 Sep 25.

Abstract

Aim: To describe recent evolution in treatment patterns and outcomes for advanced melanoma (AMel).

Methods: This retrospective observational study analyzed de-identified electronic health record data from the Flatiron Health database for 1140 adult patients who initiated first-line therapy for AMel from 1 January 2014 to 30 June 2016 with follow-up through 28 February 2017.

Results: The most common first-line regimens were ipilimumab-based therapies (34%), anti-PD-1 monotherapy (26%) and BRAF/MEK inhibitor(s) (20%). First-line ipilimumab-based and BRAF inhibitor regimens decreased after the third quarter of 2014 (3Q2014), and by 2Q2016, 55 and 91% of BRAF-mutant and BRAF wild-type cohorts, respectively, received a first-line anti-PD-1 regimen. Median overall survival from first-line initiation for all patients was 18.8 months (95% CI: 16.3-23.3).

Conclusion: Results illustrate changing paradigms of therapy and real-world patient outcomes for AMel.

Keywords: advanced melanoma; antineoplastic therapy; community oncology practice; immuno-oncology; observational study; overall survival; treatment pattern.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers, Tumor
  • Combined Modality Therapy
  • Disease Management
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Medical Oncology* / methods
  • Medical Oncology* / statistics & numerical data
  • Melanoma / epidemiology*
  • Melanoma / mortality
  • Melanoma / pathology
  • Melanoma / therapy
  • Middle Aged
  • Neoplasm Staging
  • Outcome Assessment, Health Care
  • Practice Patterns, Physicians'*
  • Treatment Outcome
  • Young Adult

Substances

  • Biomarkers, Tumor