Sustained improved survival of patients with metastatic melanoma after the introduction of anti-PD-1-based therapies

• Published in: European journal of cancer (1990) 2023-12, Vol.195, p.113392-113392, Article 113392
• Main Authors: Schina, Aimilia, Pedersen, Sidsel, Spenning, Anne-Louise, Laursen, Olivia Kaas, Pedersen, Cecilia, Haslund, Charlotte Aaquist, Schmidt, Henrik, Bastholt, Lars, Svane, Inge Marie, Ellebaek, Eva, Donia, Marco
• Format: Article
• Language: English
• ISSN: 0959-8049; 1879-0852
• DOI: 10.1016/j.ejca.2023.113392

BACKGROUNDThe introduction of modern therapies improved the median survival of patients with metastatic melanoma (MM). Here, we determined the real-world impact of modern treatments on the long-term survival of MM.METHODSIn a population-based study, we extracted all cases of MM diagnosed in four non-consecutive years marked by major changes in available 1st line treatments (2012, 2014, 2016, and 2018) from the Danish MM Database. Patients were grouped into "trial-like" and "trial-excluded" based on common trial eligibility criteria.RESULTSWe observed a sustained improved survival of "trial-like" patients diagnosed in 2016 or in 2018, compared to 2012 or 2014, but no major differences in 2018 versus 2016. In contrast, while survival of "trial-excluded" patients in 2016 was better compared to 2014 and 2012, survival in 2018 was improved over all previous years. We then developed a prognostic model based on multivariable stratified Cox regression, to predict the survival of newly diagnosed MM patients. Internal validation showed excellent discrimination and calibration, with a time-area-under-the-curve above 0.79 at multiple time horizons, for up to four years after diagnosis.CONCLUSIONSThe introduction of modern treatments such as anti-PD-1 has led to a sustained, improved survival of real-world patients with MM, regardless of their eligibility for clinical trials. We provide an updateable prognostic model that can be used to improve patient information. Overall, these data highlight a positive population-based impact of modern treatments and can help health technology assessment agencies worldwide to evaluate the appropriateness of drug pricing based on known cost-benefit data.