Analysis of Treatment Patterns for Mucosal Melanoma Using Real-World Data in the SEER-Medicare-Linked Database

Area of Science:

• Oncology
• Medical Research
• Clinical Data Analysis

Background:

• Mucosal melanoma (MM) is a rare and aggressive cancer with late diagnosis and poor prognosis.
• Surgical resection is the primary curative option, but its feasibility is limited by anatomical complexity.
• Real-world data on MM treatment patterns are scarce.

Purpose of the Study:

• To analyze treatment patterns across therapy lines for patients diagnosed with mucosal melanoma.
• To investigate treatment variations based on surgical intervention, primary tumor site, and disease stage.
• To provide insights into current clinical practices for managing MM in the US.

Main Methods:

• Retrospective analysis of SEER-Medicare-linked data (2014-2021).
• Identification of patients aged 65+ with MM using SEER and ICD-O-3 codes.
• Categorization into surgical and nonsurgical cohorts to assess systemic therapy use across treatment lines.

Main Results:

• Of 1362 MM patients, 41.3% underwent surgery. Among surgical patients, 36.2% received adjuvant systemic therapy, predominantly PD-1/PD-L1 regimens (51.5%).
• In the nonsurgical cohort, 63.3% received first-line systemic therapy, with PD-1/PD-L1 regimens dominating (66.6%).
• Treatment intensity, including combination regimens, was higher in rectal/anal melanoma, nasal cavity melanoma, and advanced-stage disease.

Conclusions:

• Treatment patterns for MM exhibit significant heterogeneity based on anatomical location and disease stage.
• Combination regimens are more prevalent in non-surgical patients and high-risk subsites, suggesting more complex disease presentations.
• The observed treatment intensity highlights the need for intensified therapeutic strategies despite potential toxicity risks.