Nationwide Outcomes of Advanced Melanoma According to BRAF(V600) Status

J. van Breeschoten*, M.W.J.M. Wouters, L.C. de Wreede, D.H. Hilarius, J.B. Haanen, C.U. Blank, M.J.B. Aarts, F.W.P.J. van den Berkmortel, J.W.B. de Groot, G.A.P. Hospers, E. Kapiteijn, D. Piersma, R.S. van Rijn, K.P.M. Suijkerbuijk, W.A.M. Blokx, A.J. ten Tije, A.A.M. van der Veldt, G. Vreugdenhil, M.J. Boers, A.J.M. van den Eertwegh

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

2 Citations (Web of Science)

Abstract

Objective: The aim of this study was to evaluate treatment patterns and overall survival (OS) of patients with BRAF(V600) wild-type and BRAF(V600)-mutant advanced melanoma in the Netherlands. Methods: We selected patients of 18 years and over, diagnosed between 2016 and 2017 with unresectable stage IIIC or IV melanoma, registered in the Dutch Melanoma Treatment Registry. To assess the association of BRAF(V600)-mutation status with OS we used the Cox proportional-hazards model. Results: A total of 642 BRAF(V600) wild-type and 853 mutant patients were included in the analysis. Median OS did not differ significantly between both groups, 15.2 months (95% confidence interval [CI]: 13.2-19.2) versus 20.6 months (95% CI: 18.3-25.0). Survival rates at 6 and 12 months were significantly lower for BRAF(V600) wild-type patients compared with BRAF(V600)-mutant patients, 72.0% (95% CI: 68.6-75.6) and 56.0% (95% CI: 52.2-60.0) versus 83.4% (95% CI: 80.9-85.9) and 65.7% (95% CI: 62.6-69.0). Two-year survival was not significantly different between both groups, 41.1% (95% CI: 37.2-45.3) versus 47.0% (95% CI: 43.6-60.6). Between 0 and 10 months, BRAF(V600) wild-type patients had a decreased survival with a hazard ratio for OS of 2.00 (95% CI: 1.62-2.46) but this effect disappeared after 10 months. At 12 months, BRAF(V600)-mutant patients had started with second-line systemic treatment more often compared with BRAF(V600) wild-type patients (50% vs. 19%). Conclusion: These results suggest that advanced BRAF(V600) wild-type melanoma patients have worse survival than BRAF(V600)-mutated patients during the first 10 months after diagnosis because of less available treatment options.
Original languageEnglish
Pages (from-to)82-89
Number of pages8
JournalAmerican Journal of Clinical Oncology-Cancer Clinical Trials
Volume44
Issue number2
DOIs
Publication statusPublished - 1 Feb 2021

Keywords

  • advanced melanoma
  • anti-pd-1-ligands
  • braf
  • braf mutation
  • checkpoint inhibitors
  • ctla-4 inhibitor
  • mek inhibitors
  • national registry
  • MEK inhibitors
  • BRAF
  • anti-PD-1-ligands
  • BRAF mutation
  • CTLA-4 inhibitor
  • National Registry

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