Real-world effectiveness of systemic anticancer therapy for advanced melanoma in the west of Scotland from 2010 to 2018

Abstract

Aim: Assess the real-world effectiveness of systemic anticancer therapy in advanced (unresectable or metastatic) melanoma. Methods: This was a retrospective cohort study linking routine healthcare data with systemic anticancer therapy prescriptions for patients starting immunotherapy or targeted treatments between 1 November 2010 and 31 December 2017 in the west of Scotland. Results: Among 362 patients identified, median overall survival varied between 18.5 months (95% CI: 14.4–not estimable) for ipilimumab/nivolumab combination and 5.6 months (95% CI: 4.5–7.3) for dabrafenib, but there were differences in the characteristics of each regimen cohort. Raised lactate dehydrogenase levels and Eastern Cooperative Oncology Group performance status ≥2 negatively impacted overall survival. Conclusion: The patients had a shorter median overall survival than those in pivotal trials. This was expected, given that this real-world cohort included patients with poorer prognostic indicators, typically excluded from trials.

Keywords::

• immunotherapy
• metastatic melanoma
• real-world evidence
• routine clinical practice
• targeted therapy

Supplementary data

To view the supplementary data that accompany this paper please visit the journal website at: www.futuremedicine.com/doi/suppl/10.2217/fon-2022-0959

Acknowledgments

This work is only possible because of the wealth of information routinely collected by the NHS as part of patient care.

Financial & competing interests disclosure

This study is part of the Cancer Medicines Outcomes Programme, funded by the Scottish government. The funder had no role in the study design, data collection, data analysis or interpretation of the data or in the preparation, review or approval of the manuscript for publication. A Waterston: funding from MSD and BMS for attendance at conferences. K Baillie: attendance at the 2019–2021 PM Clinical Leadership in Pharmacy (CLIP) Scotland program, which is sponsored/funded by Daiichi Sankyo UK Ltd, GlaxoSmithKline Plc and Napp Pharmaceuticals Ltd, outside the submitted work. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Ethical conduct of research

The authors state that they have obtained appropriate institutional review board approval or have followed the principles outlined in the Declaration of Helsinki for all human or animal experimental investigations. In addition, for investigations involving human subjects, informed consent has been obtained from the participants involved.

Additional information

Funding

This study is part of the Cancer Medicines Outcomes Programme, funded by the Scottish government. The funder had no role in the study design, data collection, data analysis or interpretation of the data or in the preparation, review or approval of the manuscript for publication. A Waterston: funding from MSD and BMS for attendance at conferences. K Baillie: attendance at the 2019–2021 PM Clinical Leadership in Pharmacy (CLIP) Scotland program, which is sponsored/funded by Daiichi Sankyo UK Ltd, GlaxoSmithKline Plc and Napp Pharmaceuticals Ltd, outside the submitted work. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.