Understanding Real-World Treatment Patterns and Clinical Outcomes among Metastatic Melanoma Patients in Alberta, Canada
Immunotherapy and targeted therapies have been shown to considerably improve long-term survival outcomes in metastatic melanoma patients. Real-world evidence on the uptake of novel therapies and outcomes for this patient population in Canada are limited. We conducted a population-based retrospective...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-04-01
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| Series: | Current Oncology |
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| Online Access: | https://www.mdpi.com/1718-7729/30/4/317 |
| _version_ | 1797605778932105216 |
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| author | Dylan E. O’Sullivan Devon J. Boyne Priyanka Gogna Darren R. Brenner Winson Y. Cheung |
| author_facet | Dylan E. O’Sullivan Devon J. Boyne Priyanka Gogna Darren R. Brenner Winson Y. Cheung |
| author_sort | Dylan E. O’Sullivan |
| collection | DOAJ |
| description | Immunotherapy and targeted therapies have been shown to considerably improve long-term survival outcomes in metastatic melanoma patients. Real-world evidence on the uptake of novel therapies and outcomes for this patient population in Canada are limited. We conducted a population-based retrospective cohort study of all metastatic melanoma patients diagnosed in Alberta, Canada (2015–2018) using electronic medical records and administrative data. Information on <i>BRAF</i> testing for patients diagnosed in 2017 or 2018 was obtained through chart abstraction. In total, 434 metastatic melanoma patients were included, of which 110 (25.3%) were de novo metastatic cases. The median age at diagnosis was 66 years (IQR: 57–76) and 70.0% were men. <i>BRAF</i> testing was completed for the majority of patients (88.7%). Among all patients, 60.4%, 19.1%, and 6.0% initiated first-line, second-line, and third-line systemic therapy. The most common therapies were anti-PD-1 and targeted therapies. The two-year survival probability from first-line therapy, second-line therapy, and third-line therapy was 0.50 (95% CI: 0.44–0.57), 0.26 (95% CI: 0.17–0.40), and 0.14 (95% CI: 0.40–0.46), respectively. In the first-line setting, survival was highest for patients that received ipilimumab or ipilimumab plus nivolumab, while targeted therapy had the highest survival in the second-line setting. This study indicates that novel therapies improve survival in the real world but a considerable proportion of patients do not receive treatment with systemic therapy. |
| first_indexed | 2024-03-11T05:05:51Z |
| format | Article |
| id | doaj.art-3f665b4e91c542b98233d44765fec296 |
| institution | Directory Open Access Journal |
| issn | 1198-0052 1718-7729 |
| language | English |
| last_indexed | 2024-03-11T05:05:51Z |
| publishDate | 2023-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Current Oncology |
| spelling | doaj.art-3f665b4e91c542b98233d44765fec2962023-11-17T18:53:03ZengMDPI AGCurrent Oncology1198-00521718-77292023-04-013044166417610.3390/curroncol30040317Understanding Real-World Treatment Patterns and Clinical Outcomes among Metastatic Melanoma Patients in Alberta, CanadaDylan E. O’Sullivan0Devon J. Boyne1Priyanka Gogna2Darren R. Brenner3Winson Y. Cheung4Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, AB T2S 3C3, CanadaDepartment of Oncology, University of Calgary, Calgary, AB T2N 4N2, CanadaDepartment of Public Health Sciences, Queen’s University, Kingston, ON K7L 3N6, CanadaDepartment of Oncology, University of Calgary, Calgary, AB T2N 4N2, CanadaDepartment of Oncology, University of Calgary, Calgary, AB T2N 4N2, CanadaImmunotherapy and targeted therapies have been shown to considerably improve long-term survival outcomes in metastatic melanoma patients. Real-world evidence on the uptake of novel therapies and outcomes for this patient population in Canada are limited. We conducted a population-based retrospective cohort study of all metastatic melanoma patients diagnosed in Alberta, Canada (2015–2018) using electronic medical records and administrative data. Information on <i>BRAF</i> testing for patients diagnosed in 2017 or 2018 was obtained through chart abstraction. In total, 434 metastatic melanoma patients were included, of which 110 (25.3%) were de novo metastatic cases. The median age at diagnosis was 66 years (IQR: 57–76) and 70.0% were men. <i>BRAF</i> testing was completed for the majority of patients (88.7%). Among all patients, 60.4%, 19.1%, and 6.0% initiated first-line, second-line, and third-line systemic therapy. The most common therapies were anti-PD-1 and targeted therapies. The two-year survival probability from first-line therapy, second-line therapy, and third-line therapy was 0.50 (95% CI: 0.44–0.57), 0.26 (95% CI: 0.17–0.40), and 0.14 (95% CI: 0.40–0.46), respectively. In the first-line setting, survival was highest for patients that received ipilimumab or ipilimumab plus nivolumab, while targeted therapy had the highest survival in the second-line setting. This study indicates that novel therapies improve survival in the real world but a considerable proportion of patients do not receive treatment with systemic therapy.https://www.mdpi.com/1718-7729/30/4/317metastatic melanomapopulation-based studyimmunotherapytargeted therapylines of therapyoverall survival |
| spellingShingle | Dylan E. O’Sullivan Devon J. Boyne Priyanka Gogna Darren R. Brenner Winson Y. Cheung Understanding Real-World Treatment Patterns and Clinical Outcomes among Metastatic Melanoma Patients in Alberta, Canada Current Oncology metastatic melanoma population-based study immunotherapy targeted therapy lines of therapy overall survival |
| title | Understanding Real-World Treatment Patterns and Clinical Outcomes among Metastatic Melanoma Patients in Alberta, Canada |
| title_full | Understanding Real-World Treatment Patterns and Clinical Outcomes among Metastatic Melanoma Patients in Alberta, Canada |
| title_fullStr | Understanding Real-World Treatment Patterns and Clinical Outcomes among Metastatic Melanoma Patients in Alberta, Canada |
| title_full_unstemmed | Understanding Real-World Treatment Patterns and Clinical Outcomes among Metastatic Melanoma Patients in Alberta, Canada |
| title_short | Understanding Real-World Treatment Patterns and Clinical Outcomes among Metastatic Melanoma Patients in Alberta, Canada |
| title_sort | understanding real world treatment patterns and clinical outcomes among metastatic melanoma patients in alberta canada |
| topic | metastatic melanoma population-based study immunotherapy targeted therapy lines of therapy overall survival |
| url | https://www.mdpi.com/1718-7729/30/4/317 |
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