Survival outcomes of patients with advanced melanoma from 2013 to 2017: Results of a nationwide population-based registry
van Zeijl, M. C.T.; de Wreede, L. C.; van den Eertwegh, A. J.M.; Wouters, M. W.J.M.; Jochems, A.; Schouwenburg, M. G.; Aarts, M. J.B.; van Akkooi, A. C.J.; van den Berkmortel, F. W.P.J.; de Groot, J. W.B.; Hospers, G. A.P.; Kapiteijn, E.; Piersma, D.; van Rijn, R. S.; Suijkerbuijk, K. P.M.; ten Tije, A. J.; van der Veldt, A. A.M.; Vreugdenhil, G.; van der Hoeven, J. J.M.; Haanen, J. B.A.G.
(2021) European Journal of Cancer, volume 144, pp. 242 - 251
(Article)
Abstract
Background: The treatment landscape has completely changed for advanced melanoma. We report survival outcomes and the differential impact of prognostic factors over time in daily clinical practice. Methods: From a Dutch nationwide population-based registry, patients with advanced melanoma diagnosed from 2013 to 2017 were analysed (n = 3616). Because the
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proportional hazards assumption was violated, a multivariable Cox model restricted to the first 6 months and a multivariable landmark Cox model from 6 to 48 months were used to assess overall survival (OS) of cases without missing values. The 2017 cohort was excluded from this analysis because of the short follow-up time. Results: Median OS of the 2013 and 2016 cohort was 11.7 months (95% confidence interval [CI]: 10.4–13.5) and 17.7 months (95% CI: 14.9–19.8), respectively. Compared with the 2013 cohort, the 2016 cohort had superior survival in the Cox model from 0 to 6 months (hazard ratio [HR] = 0.55 [95% CI: 0.43–0.72]) and in the Cox model from 6 to 48 months (HR = 0.68 [95% CI: 0.57–0.83]). Elevated lactate dehydrogenase levels, distant metastases in ≥3 organ sites, brain and liver metastasis and Eastern Cooperative Oncology Group performance score of ≥1 had stronger association with inferior survival from 0 to 6 months than from 6 to 48 months. BRAF-mutated melanoma had superior survival in the first 6 months (HR = 0.50 [95% CI: 0.42–0.59]). Conclusion(s): Prognosis for advanced melanoma in the Netherlands has improved from 2013 to 2016. Prognostic importance of most evaluated factors was higher in the first 6 months after diagnosis. BRAF-mutated melanoma was only associated with superior survival in the first 6 months.
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Keywords: Advanced melanoma, Immunotherapy, Nationwide, Population-based, Real-world, Targeted therapy, Oncology, Cancer Research
ISSN: 0959-8049
Publisher: Elsevier Limited
Note: Funding Information: For the Dutch Melanoma Treatment Registry, the Dutch Institute for Clinical Auditing foundation received a start-up grant from governmental organisation The Netherlands Organization for Health Research and Development (ZonMW, project number 836002002). The DMTR is structurally funded by Bristol-Myers Squibb , Merck Sharpe & Dohme, Novartis and Roche Pharma. Roche Pharma stopped funding in 2019 and Pierre Fabre started funding of the DMTR in 2019. For this work no funding was granted. Funding Information: For the Dutch Melanoma Treatment Registry, the Dutch Institute for Clinical Auditing foundation received a start-up grant from governmental organisation The Netherlands Organization for Health Research and Development (ZonMW, project number 836002002). The DMTR is structurally funded by Bristol-Myers Squibb, Merck Sharpe & Dohme, Novartis and Roche Pharma. Roche Pharma stopped funding in 2019 and Pierre Fabre started funding of the DMTR in 2019. For this work no funding was granted. Publisher Copyright: © 2020 Elsevier Ltd
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