The unfavorable effects of COVID-19 on Dutch advanced melanoma care
Van Not, Olivier J; van Breeschoten, Jesper; van den Eertwegh, Alfonsus J M; Hilarius, Doranne L; De Meza, Melissa M; Haanen, John B; Blank, Christian U; Aarts, Maureen J B; van den Berkmortel, Franchette W P J; de Groot, Jan Willem B; Hospers, Geke A P; Ismail, Rawa K; Kapiteijn, Ellen; Piersma, Djura; van Rijn, Rozemarijn S; Stevense-den Boer, Marion A M; van der Veldt, Astrid A M; Vreugdenhil, Gerard; Boers-Sonderen, Marye J; Blokx, Willeke A M; Suijkerbuijk, Karijn P M; Wouters, Michel W J M
(2022) International Journal of Cancer, volume 150, issue 5, pp. 816 - 824
(Article)
Abstract
The COVID-19 pandemic had a severe impact on medical care. Our study aims to investigate the impact of COVID-19 on advanced melanoma care in the Netherlands. We selected patients diagnosed with irresectable stage IIIc and IV melanoma during the first and second COVID-19 wave and compared them with patients diagnosed
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within the same time frame in 2018 and 2019. Patients were divided into three geographical regions. We investigated baseline characteristics, time from diagnosis until start of systemic therapy and postponement of anti-PD-1 courses. During both waves, fewer patients were diagnosed compared to the control groups. During the first wave, time between diagnosis and start of treatment was significantly longer in the southern region compared to other regions (33 vs 9 and 15 days, P-value <.05). Anti-PD-1 courses were postponed in 20.0% vs 3.0% of patients in the first wave compared to the control period. Significantly more patients had courses postponed in the south during the first wave compared to other regions (34.8% vs 11.5% vs 22.3%, P-value <.001). Significantly more patients diagnosed during the second wave had brain metastases and worse performance status compared to the control period. In conclusion, advanced melanoma care in the Netherlands was severely affected by the COVID-19 pandemic. In the south, the start of systemic treatment for advanced melanoma was more often delayed, and treatment courses were more frequently postponed. During the second wave, patients were diagnosed with poorer patient and tumor characteristics. Longer follow-up is needed to establish the impact on patient outcomes.
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Keywords: advanced melanoma, clinical outcomes, COVID-19, nationwide registry, systemic therapy, Oncology, Cancer Research, Journal Article
ISSN: 0020-7136
Publisher: John Wiley & Sons Inc.
Note: Funding Information: For the Dutch Melanoma Treatment Registry (DMTR), the Dutch Institute for Clinical Auditing foundation received a start‐up grant from governmental organization 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 the DMTR in 2019. For this work, no funding was granted. Publisher Copyright: © 2021 The Authors. International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.
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