Implementation and Effectiveness of Novel Therapeutic Substances for Advanced Malignant Melanoma in Saxony, Germany, 2010–2020—Cohort Study Based on Administrative Data
(1) Background: Targeted (TT) and immune checkpoint inhibitor (ICI) therapies have become available in the routine care of metastatic melanoma in recent years. (2) Objective: We compared mortality in patients with metastatic melanoma and different systemic therapies. (3) Methods: A retrospective coh...
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| Format: | Article |
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MDPI AG
2021-12-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/13/24/6150 |
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| author | Thomas Datzmann Jochen Schmitt Saskia Fuhrmann Martin Roessler Friedegund Meier Olaf Schoffer |
| author_facet | Thomas Datzmann Jochen Schmitt Saskia Fuhrmann Martin Roessler Friedegund Meier Olaf Schoffer |
| author_sort | Thomas Datzmann |
| collection | DOAJ |
| description | (1) Background: Targeted (TT) and immune checkpoint inhibitor (ICI) therapies have become available in the routine care of metastatic melanoma in recent years. (2) Objective: We compared mortality in patients with metastatic melanoma and different systemic therapies. (3) Methods: A retrospective cohort study, based on pseudonymized health insurance data of about two million individuals from Saxony, Germany, was conducted for the years 2010 to 2020. Only patients with an advanced stage, i.e., distant metastases were considered for the main analysis. Relative survival since metastasis and predicted survivor curves derived from a Cox model were used to assess potential differences in mortality. (4) Results: Relative survival was highest in the subgroup with sequential use of ICI and TT. All treatments except interferon had significant hazard ratios (HR) in the Cox model with time-dependent effects indicating a protective effect after treatment initiation (HR 0.01–0.146) but decreasing over time (HR 1.351–2.310). The predicted survivor curves revealed best survival under ICI-TT treatment and worst survival under TT treatment alone. (5) Conclusions: We found real-world evidence for survival benefits of patients with metastatic melanoma who received sequential ICI and TT treatment. It is conceivable that the observed high survival differences were overestimated due to bias, such as confounding by indication. |
| first_indexed | 2024-03-10T04:32:12Z |
| format | Article |
| id | doaj.art-ddc0fa6a38ba4416a5383e187aa49d81 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-10T04:32:12Z |
| publishDate | 2021-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-ddc0fa6a38ba4416a5383e187aa49d812023-11-23T04:04:19ZengMDPI AGCancers2072-66942021-12-011324615010.3390/cancers13246150Implementation and Effectiveness of Novel Therapeutic Substances for Advanced Malignant Melanoma in Saxony, Germany, 2010–2020—Cohort Study Based on Administrative DataThomas Datzmann0Jochen Schmitt1Saskia Fuhrmann2Martin Roessler3Friedegund Meier4Olaf Schoffer5National Center for Tumor Diseases, 01307 Dresden, GermanyNational Center for Tumor Diseases, 01307 Dresden, GermanyMedizinische Fakultät Carl Gustav Carus, Center for Evidence-Based Healthcare, TU Dresden, 01307 Dresden, GermanyMedizinische Fakultät Carl Gustav Carus, Center for Evidence-Based Healthcare, TU Dresden, 01307 Dresden, GermanyNational Center for Tumor Diseases, 01307 Dresden, GermanyMedizinische Fakultät Carl Gustav Carus, Center for Evidence-Based Healthcare, TU Dresden, 01307 Dresden, Germany(1) Background: Targeted (TT) and immune checkpoint inhibitor (ICI) therapies have become available in the routine care of metastatic melanoma in recent years. (2) Objective: We compared mortality in patients with metastatic melanoma and different systemic therapies. (3) Methods: A retrospective cohort study, based on pseudonymized health insurance data of about two million individuals from Saxony, Germany, was conducted for the years 2010 to 2020. Only patients with an advanced stage, i.e., distant metastases were considered for the main analysis. Relative survival since metastasis and predicted survivor curves derived from a Cox model were used to assess potential differences in mortality. (4) Results: Relative survival was highest in the subgroup with sequential use of ICI and TT. All treatments except interferon had significant hazard ratios (HR) in the Cox model with time-dependent effects indicating a protective effect after treatment initiation (HR 0.01–0.146) but decreasing over time (HR 1.351–2.310). The predicted survivor curves revealed best survival under ICI-TT treatment and worst survival under TT treatment alone. (5) Conclusions: We found real-world evidence for survival benefits of patients with metastatic melanoma who received sequential ICI and TT treatment. It is conceivable that the observed high survival differences were overestimated due to bias, such as confounding by indication.https://www.mdpi.com/2072-6694/13/24/6150metastatic melanomatargeted therapyimmune checkpoint inhibitor therapysurvivalstatutory health insurance data |
| spellingShingle | Thomas Datzmann Jochen Schmitt Saskia Fuhrmann Martin Roessler Friedegund Meier Olaf Schoffer Implementation and Effectiveness of Novel Therapeutic Substances for Advanced Malignant Melanoma in Saxony, Germany, 2010–2020—Cohort Study Based on Administrative Data Cancers metastatic melanoma targeted therapy immune checkpoint inhibitor therapy survival statutory health insurance data |
| title | Implementation and Effectiveness of Novel Therapeutic Substances for Advanced Malignant Melanoma in Saxony, Germany, 2010–2020—Cohort Study Based on Administrative Data |
| title_full | Implementation and Effectiveness of Novel Therapeutic Substances for Advanced Malignant Melanoma in Saxony, Germany, 2010–2020—Cohort Study Based on Administrative Data |
| title_fullStr | Implementation and Effectiveness of Novel Therapeutic Substances for Advanced Malignant Melanoma in Saxony, Germany, 2010–2020—Cohort Study Based on Administrative Data |
| title_full_unstemmed | Implementation and Effectiveness of Novel Therapeutic Substances for Advanced Malignant Melanoma in Saxony, Germany, 2010–2020—Cohort Study Based on Administrative Data |
| title_short | Implementation and Effectiveness of Novel Therapeutic Substances for Advanced Malignant Melanoma in Saxony, Germany, 2010–2020—Cohort Study Based on Administrative Data |
| title_sort | implementation and effectiveness of novel therapeutic substances for advanced malignant melanoma in saxony germany 2010 2020 cohort study based on administrative data |
| topic | metastatic melanoma targeted therapy immune checkpoint inhibitor therapy survival statutory health insurance data |
| url | https://www.mdpi.com/2072-6694/13/24/6150 |
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