Curative or non-curative: immunotherapy for advanced melanoma

Advanced melanoma was historically considered incurable; however, a 52% 10-year melanoma-specific survival rate from seminal immunotherapy trials challenges that conclusion.1 There is no literature exploring clinicians' discussion of treatment intent with patients, or whether this represents cure. We performed a multicenter retrospective cohort analysis to examine treatment intent, using electronic medical records to identify 278 patients with unresectable or stage IV melanoma consented for immunotherapy from 2019 to 2023. Thirty-two (12%) were consented for curative-intent treatment (CIT). CIT frequency was not significantly influenced by patient or disease characteristics. Patients consented for CIT received significantly higher rates of combination immunotherapy than patients consented for non-curative-intent treatment (NCIT), 76% (16/21) vs 47% (116/246), P = .022. Among 267 unresectable patients, CIT rates differed significantly between Victoria and South Australia, 14% (20/142) vs 0.8% (1/125), P < .001. Our data confirms variability of documented treatment-intent in advanced melanoma. Further research is needed to understand how this affects patients.