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Multicenter, real-life experience with checkpoint inhibitors and targeted therapy agents in advanced melanoma
Joanna Mangana1, Phil F Cheng, Corina Kaufmann
1aDepartment of Dermatology, University Hospital Zurich bUniversity of Zurich cHorten Centre for Patient Oriented Research and Knowledge Transfer, University of Zurich, Zurich dDepartment of Internal Medicine, Cantonal Hospital Aarau, Aarau eDepartment of Oncology, Cantonal Hospital Graubünden, Chur fService of Medical Oncology, Department of Oncology, University Hospital of Lausanne, Lausanne, Switzerland gUniversity of Vienna, Vienna, Austria.
Abstract:
Metastatic melanoma is a highly aggressive disease. Recent progress in immunotherapy (IT) and targeted therapy (TT) has led to significant improvements in response and survival rates in metastatic melanoma patients. The current project aims to determine the benefit of the introduction of these new therapies in advanced melanoma across several regions of Switzerland. This is a retrospective multicenter analysis of 395 advanced melanoma patients treated with standard chemotherapy, checkpoint inhibitors, and kinase inhibitors from January 2008 until December 2014. The 1-year survival was 69% (n=121) in patients treated with checkpoint inhibitors (IT), 50% in patients treated with TTs (n=113), 85% in the IT+TT group (n=66), and 38% in patients treated with standard chemotherapy (n=95). The median overall survival (mOS) from first systemic treatment in the entire study cohort was 16.9 months. mOS of patients treated either with checkpoint or kinase inhibitors (n=300, 14.6 months) between 2008 and 2014 was significantly improved (P<0.0001) compared with patients treated with standard chemotherapy in 2008-2009 (n=95, 7.4 months). mOS of 61 patients with brain metastases at stage IV was 8.1 versus 12.5 months for patients without at stage IV (n=334), therefore being significantly different (P=0.00065). Furthermore, a significant reduction in hospitalization duration compared with chemotherapy was noted. Treatment with checkpoint and kinase inhibitors beyond clinical trials significantly improves the mOS in real life and the results are consistent with published prospective trial data.
Insights
New immunotherapy and targeted therapies significantly improve survival for advanced melanoma patients compared to chemotherapy. These real-world findings in Switzerland align with clinical trial data, showing better outcomes and reduced hospital stays.
Area of Science:
- Oncology
- Dermatology
- Clinical Research
Background:
- Metastatic melanoma is an aggressive cancer with historically poor prognosis.
- Recent advancements in immunotherapy (IT) and targeted therapy (TT) offer new hope for patients.
- The real-world benefit of these novel therapies in advanced melanoma requires evaluation.
Purpose of the Study:
- To assess the effectiveness of IT and TT in advanced melanoma patients in Switzerland.
- To compare survival rates and clinical outcomes between IT, TT, and standard chemotherapy.
- To analyze the impact of these treatments on overall survival and hospitalization.
Main Methods:
- Retrospective multicenter analysis of 395 advanced melanoma patients.
- Data collected from January 2008 to December 2014.
- Patients received standard chemotherapy, checkpoint inhibitors (IT), or kinase inhibitors (TT).
Main Results:
- One-year survival rates: 69% (IT), 50% (TT), 85% (IT+TT), 38% (chemotherapy).
- Median overall survival (mOS) significantly improved with IT/TT (14.6 months) vs. chemotherapy (7.4 months) (P<0.0001).
- Brain metastases negatively impacted mOS (8.1 months vs. 12.5 months); reduced hospitalization observed with IT/TT.
Conclusions:
- Real-world treatment with checkpoint inhibitors and kinase inhibitors significantly improves mOS in advanced melanoma.
- These findings corroborate data from prospective clinical trials.
- Novel therapies offer substantial benefits beyond standard chemotherapy for metastatic melanoma.
