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Treatment reality of patients with BRAF-mutant advanced/metastatic melanoma in Switzerland in the era of choice
Cutaneous melanoma represents a major cause of cancer death in Europe. Without adequate therapy, the 5-year survival rate is 15–20% in distant metastatic disease. Evaluating the status quo of treatment standards in advanced melanoma and rationale for therapy decisions in Switzerland between January...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Lippincott Williams & Wilkins
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9997623/ https://www.ncbi.nlm.nih.gov/pubmed/35855650 http://dx.doi.org/10.1097/CMR.0000000000000843 |
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author | Mangana, Joanna Zihler, Deborah Bossart, Simon Brönnimann, Daniel Zachariah, Ralph Gérard, Camille Léa |
author_facet | Mangana, Joanna Zihler, Deborah Bossart, Simon Brönnimann, Daniel Zachariah, Ralph Gérard, Camille Léa |
author_sort | Mangana, Joanna |
collection | PubMed |
description | Cutaneous melanoma represents a major cause of cancer death in Europe. Without adequate therapy, the 5-year survival rate is 15–20% in distant metastatic disease. Evaluating the status quo of treatment standards in advanced melanoma and rationale for therapy decisions in Switzerland between January 2016 and September 2018. In this retrospective, anonymized registry, data of male and female patients with unresectable advanced/metastatic BRAF-positive cutaneous melanoma treated in first-, second- and third-line with registered substances were analyzed using descriptive statistics. Forty-one patients (56.1% male) were included providing a total of 70 treatment lines (first-line: n = 41; second-line: n = 18; and third-line: n = 11). Within the patients presenting with stage III or IV melanoma, immunotherapy with checkpoint inhibitors was more frequently administered as first-line treatment than targeted therapy (TT) (70.7% vs. 29.3%). Across all lines, patients received TT in 47.1% (predominantly combined BRAF-MEK-inhibition) and immunotherapy in 52.9% of the cases (anti-PD-1 monotherapy in 62.2% and anti-PD-1/anti-CTLA-4 combinations in 37.8%). Most commonly, the treatment type was switched from TT to immunotherapy or vice versa upon disease progression. The most frequent rationales for prescribing either TT or immunotherapy were physician’s preference (40.0%) or remission pressure (28.6%), respectively. Disease progression led to treatment discontinuation more frequently than undesired events. Patients in Switzerland with unresectable advanced or metastatic BRAF-mutant melanoma predominantly receive guideline-recommended treatments. IO was used as predominant front-line therapy, with TT/immunotherapy switch being the predominant treatment principle. Sequencing studies are underway to identify the optimal treatment regimen for those patients. 32: 366–372 Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved. |
format | Online Article Text |
id | pubmed-9997623 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Lippincott Williams & Wilkins |
record_format | MEDLINE/PubMed |
spelling | pubmed-99976232023-03-09 Treatment reality of patients with BRAF-mutant advanced/metastatic melanoma in Switzerland in the era of choice Mangana, Joanna Zihler, Deborah Bossart, Simon Brönnimann, Daniel Zachariah, Ralph Gérard, Camille Léa Melanoma Res Original Articles: Clinical Research Cutaneous melanoma represents a major cause of cancer death in Europe. Without adequate therapy, the 5-year survival rate is 15–20% in distant metastatic disease. Evaluating the status quo of treatment standards in advanced melanoma and rationale for therapy decisions in Switzerland between January 2016 and September 2018. In this retrospective, anonymized registry, data of male and female patients with unresectable advanced/metastatic BRAF-positive cutaneous melanoma treated in first-, second- and third-line with registered substances were analyzed using descriptive statistics. Forty-one patients (56.1% male) were included providing a total of 70 treatment lines (first-line: n = 41; second-line: n = 18; and third-line: n = 11). Within the patients presenting with stage III or IV melanoma, immunotherapy with checkpoint inhibitors was more frequently administered as first-line treatment than targeted therapy (TT) (70.7% vs. 29.3%). Across all lines, patients received TT in 47.1% (predominantly combined BRAF-MEK-inhibition) and immunotherapy in 52.9% of the cases (anti-PD-1 monotherapy in 62.2% and anti-PD-1/anti-CTLA-4 combinations in 37.8%). Most commonly, the treatment type was switched from TT to immunotherapy or vice versa upon disease progression. The most frequent rationales for prescribing either TT or immunotherapy were physician’s preference (40.0%) or remission pressure (28.6%), respectively. Disease progression led to treatment discontinuation more frequently than undesired events. Patients in Switzerland with unresectable advanced or metastatic BRAF-mutant melanoma predominantly receive guideline-recommended treatments. IO was used as predominant front-line therapy, with TT/immunotherapy switch being the predominant treatment principle. Sequencing studies are underway to identify the optimal treatment regimen for those patients. 32: 366–372 Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved. Lippincott Williams & Wilkins 2022-07-20 2022-10 /pmc/articles/PMC9997623/ /pubmed/35855650 http://dx.doi.org/10.1097/CMR.0000000000000843 Text en Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (https://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. |
spellingShingle | Original Articles: Clinical Research Mangana, Joanna Zihler, Deborah Bossart, Simon Brönnimann, Daniel Zachariah, Ralph Gérard, Camille Léa Treatment reality of patients with BRAF-mutant advanced/metastatic melanoma in Switzerland in the era of choice |
title | Treatment reality of patients with BRAF-mutant advanced/metastatic melanoma in Switzerland in the era of choice |
title_full | Treatment reality of patients with BRAF-mutant advanced/metastatic melanoma in Switzerland in the era of choice |
title_fullStr | Treatment reality of patients with BRAF-mutant advanced/metastatic melanoma in Switzerland in the era of choice |
title_full_unstemmed | Treatment reality of patients with BRAF-mutant advanced/metastatic melanoma in Switzerland in the era of choice |
title_short | Treatment reality of patients with BRAF-mutant advanced/metastatic melanoma in Switzerland in the era of choice |
title_sort | treatment reality of patients with braf-mutant advanced/metastatic melanoma in switzerland in the era of choice |
topic | Original Articles: Clinical Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9997623/ https://www.ncbi.nlm.nih.gov/pubmed/35855650 http://dx.doi.org/10.1097/CMR.0000000000000843 |
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