Real World Outcomes in Patients with Advanced Melanoma Treated in Alberta, Canada: A Time-Era Based Analysis
Immune checkpoint and MAP kinase pathway inhibitors can significantly improve long-term survival for patients with melanoma. There is limited real-world data of these regimens’ effectiveness. We retrospectively analyzed 402 patients with unresectable and metastatic melanoma between August 2013 and J...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-10-01
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| Series: | Current Oncology |
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| Online Access: | https://www.mdpi.com/1718-7729/28/5/338 |
| _version_ | 1797514843600715776 |
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| author | Rodrigo Rigo Jordan Doherty Kim Koczka Shiying Kong Philip Q. Ding Tina Cheng Winson Y. Cheung Jose G. Monzon |
| author_facet | Rodrigo Rigo Jordan Doherty Kim Koczka Shiying Kong Philip Q. Ding Tina Cheng Winson Y. Cheung Jose G. Monzon |
| author_sort | Rodrigo Rigo |
| collection | DOAJ |
| description | Immune checkpoint and MAP kinase pathway inhibitors can significantly improve long-term survival for patients with melanoma. There is limited real-world data of these regimens’ effectiveness. We retrospectively analyzed 402 patients with unresectable and metastatic melanoma between August 2013 and July 2020 treated with immune checkpoint inhibitors and MAP kinase pathway targeted therapy in Alberta, Canada. Overall survival (OS) was compared using Kaplan–Meier and Cox regression analyses. Subgroup survival outcomes were analyzed by first-line treatment regime and <i>BRAF</i> mutation status. Three treatment eras were defined based on drug access: prior to August 2013, August 2013 to November 2016, and November 2016 to July 2020. Across each era, there were improvements in median OS: 11.7 months, 15.9 months, and 33.6 months, respectively. Patients with BRAF mutant melanoma had improved median OS when they were treated with immunotherapy in the first line as opposed to targeted therapy (median OS not reached for immunotherapy versus 17.4 months with targeted treatment). Patients with <i>BRAF</i> wild-type melanomas had improved survival with ipilimumab and nivolumab versus those treated with a single-agent PD-1 inhibitor (median OS not reached and 21.2 months). Our real-world analysis confirms significant survival improvements with each subsequent introduction of novel therapies for advanced melanoma. |
| first_indexed | 2024-03-10T06:37:18Z |
| format | Article |
| id | doaj.art-1ed2b878f5f14461985de358d55e844e |
| institution | Directory Open Access Journal |
| issn | 1198-0052 1718-7729 |
| language | English |
| last_indexed | 2024-03-10T06:37:18Z |
| publishDate | 2021-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Current Oncology |
| spelling | doaj.art-1ed2b878f5f14461985de358d55e844e2023-11-22T17:55:13ZengMDPI AGCurrent Oncology1198-00521718-77292021-10-012853978398610.3390/curroncol28050338Real World Outcomes in Patients with Advanced Melanoma Treated in Alberta, Canada: A Time-Era Based AnalysisRodrigo Rigo0Jordan Doherty1Kim Koczka2Shiying Kong3Philip Q. Ding4Tina Cheng5Winson Y. Cheung6Jose G. Monzon7Tom Baker Cancer Centre, Division of Medical Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, CanadaCambridge Memorial Hospital, Cambridge, ON N1R 3G2, CanadaTom Baker Cancer Centre, Division of Medical Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, CanadaCentre for Health Informatics, University of Calgary, Calgary, AB T2N 1N4, CanadaOncology Outcomes Research Initiative, University of Calgary, Calgary, AB T2N 1N4, CanadaTom Baker Cancer Centre, Division of Medical Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, CanadaTom Baker Cancer Centre, Division of Medical Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, CanadaTom Baker Cancer Centre, Division of Medical Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, CanadaImmune checkpoint and MAP kinase pathway inhibitors can significantly improve long-term survival for patients with melanoma. There is limited real-world data of these regimens’ effectiveness. We retrospectively analyzed 402 patients with unresectable and metastatic melanoma between August 2013 and July 2020 treated with immune checkpoint inhibitors and MAP kinase pathway targeted therapy in Alberta, Canada. Overall survival (OS) was compared using Kaplan–Meier and Cox regression analyses. Subgroup survival outcomes were analyzed by first-line treatment regime and <i>BRAF</i> mutation status. Three treatment eras were defined based on drug access: prior to August 2013, August 2013 to November 2016, and November 2016 to July 2020. Across each era, there were improvements in median OS: 11.7 months, 15.9 months, and 33.6 months, respectively. Patients with BRAF mutant melanoma had improved median OS when they were treated with immunotherapy in the first line as opposed to targeted therapy (median OS not reached for immunotherapy versus 17.4 months with targeted treatment). Patients with <i>BRAF</i> wild-type melanomas had improved survival with ipilimumab and nivolumab versus those treated with a single-agent PD-1 inhibitor (median OS not reached and 21.2 months). Our real-world analysis confirms significant survival improvements with each subsequent introduction of novel therapies for advanced melanoma.https://www.mdpi.com/1718-7729/28/5/338melanomaoverall survivalipilimumabnivolumabtargeted therapy<i>BRAF</i> mutation |
| spellingShingle | Rodrigo Rigo Jordan Doherty Kim Koczka Shiying Kong Philip Q. Ding Tina Cheng Winson Y. Cheung Jose G. Monzon Real World Outcomes in Patients with Advanced Melanoma Treated in Alberta, Canada: A Time-Era Based Analysis Current Oncology melanoma overall survival ipilimumab nivolumab targeted therapy <i>BRAF</i> mutation |
| title | Real World Outcomes in Patients with Advanced Melanoma Treated in Alberta, Canada: A Time-Era Based Analysis |
| title_full | Real World Outcomes in Patients with Advanced Melanoma Treated in Alberta, Canada: A Time-Era Based Analysis |
| title_fullStr | Real World Outcomes in Patients with Advanced Melanoma Treated in Alberta, Canada: A Time-Era Based Analysis |
| title_full_unstemmed | Real World Outcomes in Patients with Advanced Melanoma Treated in Alberta, Canada: A Time-Era Based Analysis |
| title_short | Real World Outcomes in Patients with Advanced Melanoma Treated in Alberta, Canada: A Time-Era Based Analysis |
| title_sort | real world outcomes in patients with advanced melanoma treated in alberta canada a time era based analysis |
| topic | melanoma overall survival ipilimumab nivolumab targeted therapy <i>BRAF</i> mutation |
| url | https://www.mdpi.com/1718-7729/28/5/338 |
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