Abstract
Aim: Assess the real-world effectiveness of systemic anticancer therapy in advanced (unresectable or metastatic) melanoma. Methods: This was a retrospective cohort study linking routine healthcare data with systemic anticancer therapy prescriptions for patients starting immunotherapy or targeted treatments between 1 November 2010 and 31 December 2017 in the west of Scotland. Results: Among 362 patients identified, median overall survival varied between 18.5 months (95% CI: 14.4-not estimable) for ipilimumab/nivolumab combination and 5.6 months (95% CI: 4.5-7.3) for dabrafenib, but there were differences in the characteristics of each regimen cohort. Raised lactate dehydrogenase levels and Eastern Cooperative Oncology Group performance status =2 negatively impacted overall survival. Conclusion: The patients had a shorter median overall survival than those in pivotal trials. This was expected, given that this real-world cohort included patients with poorer prognostic indicators, typically excluded from trials.
| Original language | English |
|---|---|
| Pages (from-to) | 451-461 |
| Number of pages | 11 |
| Journal | Future Oncology |
| Volume | 19 |
| Issue number | 6 |
| Early online date | 11 Apr 2023 |
| DOIs | |
| Publication status | E-pub ahead of print - 11 Apr 2023 |
Funding
This study was undertaken as part of the Cancer Medicines Outcomes Programme, funded by the Scottish government in 2016 as part of the ‘Beating Cancer: Ambition and Action’ cancer plan []. The primary aim was to determine the clinical outcomes of patients receiving SACT for MM in the west of Scotland, using electronic record linkage (ERL) of routinely captured administrative healthcare data. A secondary aim was to test the validity of using ERL as opposed to using patient case notes, the most commonly used method, to evaluate outcomes of SACT in routine practice within the Scottish context. Using routinely captured administrative healthcare data to determine SACT outcomes, as described by Baillie et al., can provide an alternative, more efficient route to collecting real-world data (RWD) than patient case notes or disease-specific prospective registries [].
Keywords
- metastatic melanoma
- immunotherapy
- targeted treatment
- real world data
- routine clinical practice