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Treatment reality of patients with BRAF-mutant advanced/metastatic melanoma in Switzerland in the era of choice

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Titel: Treatment reality of patients with BRAF-mutant advanced/metastatic melanoma in Switzerland in the era of choice
Autoren: Mangana, Joanna, Zihler, Deborah, Bossart, Simon, Brönnimann, Daniel, Zachariah, Ralph, Gérard, Camille Léa
Weitere Verfasser: University of Zurich, Mangana, Joanna
Quelle: Melanoma Res
Melanoma research, vol. 32, no. 5, pp. 366-372
Verlagsinformationen: Ovid Technologies (Wolters Kluwer Health), 2022.
Publikationsjahr: 2022
Schlagwörter: Male, Proto-Oncogene Proteins B-raf, Cancer Research, Skin Neoplasms, Programmed Cell Death 1 Receptor, 610 Medicine & health, Dermatology, Original Articles: Clinical Research, 2708 Dermatology, 03 medical and health sciences, Melanoma, Cutaneous Malignant, 0302 clinical medicine, Humans, 1306 Cancer Research, Melanoma, Protein Kinase Inhibitors, Retrospective Studies, Disease Progression, Female, Melanoma/drug therapy, Melanoma/genetics, Neoplasms, Second Primary/chemically induced, Protein Kinase Inhibitors/therapeutic use, Proto-Oncogene Proteins B-raf/genetics, Skin Neoplasms/chemically induced, Skin Neoplasms/drug therapy, Skin Neoplasms/genetics, Switzerland, 10177 Dermatology Clinic, Neoplasms, Second Primary, 3. Good health, Oncology, 2730 Oncology
Beschreibung: Cutaneous melanoma represents a major cause of cancer death in Europe. Without adequate therapy, the 5-year survival rate is 15–20% in distant metastatic disease. Evaluating the status quo of treatment standards in advanced melanoma and rationale for therapy decisions in Switzerland between January 2016 and September 2018. In this retrospective, anonymized registry, data of male and female patients with unresectable advanced/metastatic BRAF-positive cutaneous melanoma treated in first-, second- and third-line with registered substances were analyzed using descriptive statistics. Forty-one patients (56.1% male) were included providing a total of 70 treatment lines (first-line: n = 41; second-line: n = 18; and third-line: n = 11). Within the patients presenting with stage III or IV melanoma, immunotherapy with checkpoint inhibitors was more frequently administered as first-line treatment than targeted therapy (TT) (70.7% vs. 29.3%). Across all lines, patients received TT in 47.1% (predominantly combined BRAF-MEK-inhibition) and immunotherapy in 52.9% of the cases (anti-PD-1 monotherapy in 62.2% and anti-PD-1/anti-CTLA-4 combinations in 37.8%). Most commonly, the treatment type was switched from TT to immunotherapy or vice versa upon disease progression. The most frequent rationales for prescribing either TT or immunotherapy were physician’s preference (40.0%) or remission pressure (28.6%), respectively. Disease progression led to treatment discontinuation more frequently than undesired events. Patients in Switzerland with unresectable advanced or metastatic BRAF-mutant melanoma predominantly receive guideline-recommended treatments. IO was used as predominant front-line therapy, with TT/immunotherapy switch being the predominant treatment principle. Sequencing studies are underway to identify the optimal treatment regimen for those patients. 32: 366–372 Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
Publikationsart: Article
Other literature type
Dateibeschreibung: application/pdf; Publikation_JM_Punkt_3.pdf - application/pdf
Sprache: English
ISSN: 0960-8931
DOI: 10.1097/cmr.0000000000000843
DOI: 10.5167/uzh-224124
Zugangs-URL: https://pubmed.ncbi.nlm.nih.gov/35855650
https://serval.unil.ch/resource/serval:BIB_A4E833D2057F.P001/REF.pdf
https://serval.unil.ch/notice/serval:BIB_A4E833D2057F
http://nbn-resolving.org/urn/resolver.pl?urn=urn:nbn:ch:serval-BIB_A4E833D2057F6
https://www.zora.uzh.ch/id/eprint/224124/
https://doi.org/10.5167/uzh-224124
Rights: CC BY NC ND
Dokumentencode: edsair.doi.dedup.....626ddb934c8cc854d44241a11d3380b0
Datenbank: OpenAIRE
Beschreibung
Abstract:Cutaneous melanoma represents a major cause of cancer death in Europe. Without adequate therapy, the 5-year survival rate is 15–20% in distant metastatic disease. Evaluating the status quo of treatment standards in advanced melanoma and rationale for therapy decisions in Switzerland between January 2016 and September 2018. In this retrospective, anonymized registry, data of male and female patients with unresectable advanced/metastatic BRAF-positive cutaneous melanoma treated in first-, second- and third-line with registered substances were analyzed using descriptive statistics. Forty-one patients (56.1% male) were included providing a total of 70 treatment lines (first-line: n = 41; second-line: n = 18; and third-line: n = 11). Within the patients presenting with stage III or IV melanoma, immunotherapy with checkpoint inhibitors was more frequently administered as first-line treatment than targeted therapy (TT) (70.7% vs. 29.3%). Across all lines, patients received TT in 47.1% (predominantly combined BRAF-MEK-inhibition) and immunotherapy in 52.9% of the cases (anti-PD-1 monotherapy in 62.2% and anti-PD-1/anti-CTLA-4 combinations in 37.8%). Most commonly, the treatment type was switched from TT to immunotherapy or vice versa upon disease progression. The most frequent rationales for prescribing either TT or immunotherapy were physician’s preference (40.0%) or remission pressure (28.6%), respectively. Disease progression led to treatment discontinuation more frequently than undesired events. Patients in Switzerland with unresectable advanced or metastatic BRAF-mutant melanoma predominantly receive guideline-recommended treatments. IO was used as predominant front-line therapy, with TT/immunotherapy switch being the predominant treatment principle. Sequencing studies are underway to identify the optimal treatment regimen for those patients. 32: 366–372 Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
ISSN:09608931
DOI:10.1097/cmr.0000000000000843