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Published on: February 8, 2018
Immune checkpoint inhibition and targeted therapy for melanoma: A patient-oriented cross-sectional comparative
Alexander Thiem1, Pegah Mashhadiakbar1, Christiane Cussigh2
1Clinic and Policlinic for Dermatology and Venereology, University Medical Center Rostock, Rostock, Germany.
Background:
Choosing the adequate systemic treatment for melanoma is driven by clinical parameters and personal preferences.
Objective:
Evaluation of the impact of disease and treatment on the daily life of patients receiving systemic therapy for melanoma.
Methods:
A German-wide, cross-sectional comparative study was conducted at 13 specialized skin cancer centres from 08/2020 to 03/2021. A questionnaire was distributed to assess patients' perception of disease and symptoms, the impact of their current treatment on quality of life (QOL) and activities, adverse events (AEs), therapeutic visits, as well as believe in and satisfaction with their current systemic melanoma treatment. Patient-reported outcomes (PROs) were rated on a continuous numerical rating scale or selected from a given list.
Results:
Four hundred and fourteen patients with systemic melanoma therapy were included. 359 (87%) received immune checkpoint inhibition (ICI) and 55 (13%) targeted therapy (TT). About 1/3 of patients were adjuvantly treated, the remaining because of unresectable/metastatic melanoma. In subgroup analyses, only in the adjuvant setting, TT patients reported a significant decrease in their treatment associated QOL compared to patients with ICI (p = 0.02). Patients with TT were 1.9 times more likely to report AEs than patients with ICI, a difference being significant just for the adjuvant setting (p = 0.01). ICI treatment intervals differed significantly between adjuvant and unresectable/metastatic setting (p = 0.04), though all patients, regardless of their specific ICI drug, evaluated their treatment frequency as adequate. TT patients with dabrafenib/trametinib (n = 37) or encorafenib/binimetinib (n = 15) did not differ regarding the strain of daily pill intake. Patients older than 63 years rated various PROs better than younger patients.
Conclusions:
Patients evaluated their treatment mainly positively. ICI might be preferred over TT regarding QOL and patient-reported AEs in the adjuvant setting. Older melanoma patients appeared to be less impacted by their disease and more satisfied with their treatment.
Insights
Systemic melanoma treatments impact daily life. Immune checkpoint inhibition (ICI) may offer better quality of life and fewer adverse events (AEs) than targeted therapy (TT), especially in the adjuvant setting.
Area of Science:
- Oncology
- Dermatology
- Clinical Research
Background:
- Systemic treatment selection for melanoma balances clinical factors and patient preferences.
- Understanding treatment impact on patients' daily lives is crucial.
Purpose of the Study:
- To evaluate how systemic therapy for melanoma affects patients' daily lives.
- To compare patient-reported outcomes (PROs) between different systemic treatments.
Main Methods:
- A cross-sectional study involving 414 melanoma patients across 13 German centers.
- Utilized questionnaires to assess quality of life (QOL), adverse events (AEs), and treatment satisfaction.
- Compared immune checkpoint inhibition (ICI) and targeted therapy (TT) groups.
Main Results:
- Immune checkpoint inhibition (ICI) and targeted therapy (TT) were used in 87% and 13% of patients, respectively.
- In the adjuvant setting, TT was associated with significantly lower QOL and higher AEs compared to ICI (p=0.02 and p=0.01).
- Older patients (>63 years) reported better PROs and higher treatment satisfaction.
Conclusions:
- Melanoma patients generally view their systemic treatments positively.
- Immune checkpoint inhibition (ICI) may be preferable to targeted therapy (TT) for QOL and AEs in the adjuvant setting.
- Older patients experience less disease/treatment burden and higher satisfaction.
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