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Curative or non-curative: immunotherapy for advanced melanoma.
Richard Kelly1,2,3, Abigail Miller4, Rachel Roberts-Thomson4
1Paula Fox Melanoma and Cancer Centre, The Alfred, Melbourne, Australia.
JNCI Cancer Spectrum
|April 18, 2025
Summary
Clinicians rarely discuss curative-intent treatment (CIT) for advanced melanoma patients receiving immunotherapy. Documented CIT varies significantly, impacting treatment approaches and patient outcomes.
Area of Science:
- Oncology
- Clinical Medicine
- Medical Research
Background:
- Advanced melanoma was historically deemed incurable, but immunotherapy has improved survival rates.
- Limited research exists on clinicians discussing treatment-intent, specifically "cure," with advanced melanoma patients.
Purpose of the Study:
- To examine the frequency and documentation of treatment-intent discussions in advanced melanoma patients undergoing immunotherapy.
- To investigate whether treatment-intent influences immunotherapy choices and outcomes.
Main Methods:
- Multi-center retrospective cohort analysis of 278 patients with unresectable or stage IV melanoma receiving immunotherapy (2019-2023).
- Electronic medical records were used to identify patients consented for curative-intent treatment (CIT) versus non-curative-intent treatment (NCIT).
Main Results:
- Only 12% (32/278) of patients were consented for curative-intent treatment (CIT).
- Patients receiving CIT were more likely to receive combination immunotherapy (76% vs. 47%).
- Significant regional variation in CIT rates was observed between Australian states (14% vs. 0.8%).
Conclusions:
- There is considerable variability in documented treatment-intent for advanced melanoma patients.
- Further research is required to understand the implications of documented treatment-intent on patient management and outcomes.
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