Survival outcomes of patients with advanced melanoma from 2013 to 2017: Results of a nationwide population-based registry

M.C.T. van Zeijl; L.C. de Wreede; A.J.M. van den Eertwegh; M.W.J.M. Wouters; A. Jochems; M.G. Schouwenburg; M.J.B. Aarts; A.C.J. van Akkooi; 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; A.J. Ten Tije; A.A.M. van der Veldt; G. Vreugdenhil; J.J.M. van der Hoeven; J.B.A.G. Haanen

doi:10.1016/j.ejca.2020.11.028

Survival outcomes of patients with advanced melanoma from 2013 to 2017: Results of a nationwide population-based registry

M.C.T. van Zeijl
, L.C. de Wreede
, A.J.M. van den Eertwegh
, M.W.J.M. Wouters
, A. Jochems
, M.G. Schouwenburg
, M.J.B. Aarts
, A.C.J. van Akkooi
, 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
, A.J. Ten Tije
, A.A.M. van der Veldt
, G. Vreugdenhil
, J.J.M. van der Hoeven
, J.B.A.G. Haanen^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Background: The treatment landscape has completely changed for advanced melanoma. We report survival outcomes and the differential impact of prognostic factors over time in daily clinical practice.Methods: From a Dutch nationwide population-based registry, patients with advanced melanoma diagnosed from 2013 to 2017 were analysed (n = 3616). Because the proportional hazards assumption was violated, a multivariable Cox model restricted to the first 6 months and a multivariable landmark Cox model from 6 to 48 months were used to assess overall survival (OS) of cases without missing values. The 2017 cohort was excluded from this analysis because of the short follow-up time.Results: Median OS of the 2013 and 2016 cohort was 11.7 months (95% confidence interval [CI]: 10.4-13.5) and 17.7 months (95% CI: 14.9-19.8), respectively. Compared with the 2013 cohort, the 2016 cohort had superior survival in the Cox model from 0 to 6 months (hazard ratio [HR] = 0.55 [95% CI: 0.43-0.72]) and in the Cox model from 6 to 48 months (HR = 0.68 [95% CI: 0.57-0.83]). Elevated lactate dehydrogenase levels, distant metastases in >= 3 organ sites, brain and liver metastasis and Eastern Cooperative Oncology Group performance score of >= 1 had stronger association with inferior survival from 0 to 6 months than from 6 to 48 months. BRAF-mutated melanoma had superior survival in the first 6 months (HR = 0.50 [95% CI: 0.42-0.59]).Conclusion(s): Prognosis for advanced melanoma in the Netherlands has improved from 2013 to 2016. Prognostic importance of most evaluated factors was higher in the first 6 months after diagnosis. BRAF-mutated melanoma was only associated with superior survival in the first 6 months. (C) 2020 Elsevier Ltd. All rights reserved.

Original language	English
Pages (from-to)	242-251
Number of pages	10
Journal	European Journal of Cancer
Volume	144
DOIs	https://doi.org/10.1016/j.ejca.2020.11.028
Publication status	Published - 1 Feb 2021

Keywords

advanced melanoma
combined nivolumab
double-blind
immunotherapy
ipilimumab
iv melanoma
metastatic melanoma
nationwide
pembrolizumab
phase-iii trials
pooled analysis
population-based
progression-free
real-world
targeted therapy
vemurafenib
Targeted therapy
Real-world
Advanced melanoma
Nationwide
METASTATIC MELANOMA
Population-based
Immunotherapy
IV MELANOMA
POOLED ANALYSIS
VEMURAFENIB
COMBINED NIVOLUMAB
PEMBROLIZUMAB
DOUBLE-BLIND
PROGRESSION-FREE
PHASE-III TRIALS
IPILIMUMAB

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van Zeijl, M. C. T., de Wreede, L. C., van den Eertwegh, A. J. M., Wouters, M. W. J. M., Jochems, A., Schouwenburg, M. G., Aarts, M. J. B., van Akkooi, A. C. J., van den Berkmortel, F. W. P. J., de Groot, J. W. B., Hospers, G. A. P., Kapiteijn, E., Piersma, D., van Rijn, R. S., Suijkerbuijk, K. P. M., Ten Tije, A. J., van der Veldt, A. A. M., Vreugdenhil, G., van der Hoeven, J. J. M., & Haanen, J. B. A. G. (2021). Survival outcomes of patients with advanced melanoma from 2013 to 2017: Results of a nationwide population-based registry. European Journal of Cancer, 144, 242-251. https://doi.org/10.1016/j.ejca.2020.11.028

@article{964baa7abad94caaab36ceca6f293152,

title = "Survival outcomes of patients with advanced melanoma from 2013 to 2017: Results of a nationwide population-based registry",

abstract = "Background: The treatment landscape has completely changed for advanced melanoma. We report survival outcomes and the differential impact of prognostic factors over time in daily clinical practice.Methods: From a Dutch nationwide population-based registry, patients with advanced melanoma diagnosed from 2013 to 2017 were analysed (n = 3616). Because the proportional hazards assumption was violated, a multivariable Cox model restricted to the first 6 months and a multivariable landmark Cox model from 6 to 48 months were used to assess overall survival (OS) of cases without missing values. The 2017 cohort was excluded from this analysis because of the short follow-up time.Results: Median OS of the 2013 and 2016 cohort was 11.7 months (95\% confidence interval [CI]: 10.4-13.5) and 17.7 months (95\% CI: 14.9-19.8), respectively. Compared with the 2013 cohort, the 2016 cohort had superior survival in the Cox model from 0 to 6 months (hazard ratio [HR] = 0.55 [95\% CI: 0.43-0.72]) and in the Cox model from 6 to 48 months (HR = 0.68 [95\% CI: 0.57-0.83]). Elevated lactate dehydrogenase levels, distant metastases in >= 3 organ sites, brain and liver metastasis and Eastern Cooperative Oncology Group performance score of >= 1 had stronger association with inferior survival from 0 to 6 months than from 6 to 48 months. BRAF-mutated melanoma had superior survival in the first 6 months (HR = 0.50 [95\% CI: 0.42-0.59]).Conclusion(s): Prognosis for advanced melanoma in the Netherlands has improved from 2013 to 2016. Prognostic importance of most evaluated factors was higher in the first 6 months after diagnosis. BRAF-mutated melanoma was only associated with superior survival in the first 6 months. (C) 2020 Elsevier Ltd. All rights reserved.",

keywords = "advanced melanoma, combined nivolumab, double-blind, immunotherapy, ipilimumab, iv melanoma, metastatic melanoma, nationwide, pembrolizumab, phase-iii trials, pooled analysis, population-based, progression-free, real-world, targeted therapy, vemurafenib, Targeted therapy, Real-world, Advanced melanoma, Nationwide, METASTATIC MELANOMA, Population-based, Immunotherapy, IV MELANOMA, POOLED ANALYSIS, VEMURAFENIB, COMBINED NIVOLUMAB, PEMBROLIZUMAB, DOUBLE-BLIND, PROGRESSION-FREE, PHASE-III TRIALS, IPILIMUMAB",

author = "\{van Zeijl\}, M.C.T. and \{de Wreede\}, L.C. and \{van den Eertwegh\}, A.J.M. and M.W.J.M. Wouters and A. Jochems and M.G. Schouwenburg and M.J.B. Aarts and \{van Akkooi\}, A.C.J. and \{van den Berkmortel\}, F.W.P.J. and \{de Groot\}, J.W.B. and G.A.P. Hospers and E. Kapiteijn and D. Piersma and \{van Rijn\}, R.S. and K.P.M. Suijkerbuijk and \{Ten Tije\}, A.J. and \{van der Veldt\}, A.A.M. and G. Vreugdenhil and \{van der Hoeven\}, J.J.M. and J.B.A.G. Haanen",

note = "Funding Information: For the Dutch Melanoma Treatment Registry, the Dutch Institute for Clinical Auditing foundation received a start-up grant from governmental organisation The Netherlands Organization for Health Research and Development (ZonMW, project number 836002002). The DMTR is structurally funded by Bristol-Myers Squibb , Merck Sharpe \& Dohme, Novartis and Roche Pharma. Roche Pharma stopped funding in 2019 and Pierre Fabre started funding of the DMTR in 2019. For this work no funding was granted. Funding Information: For the Dutch Melanoma Treatment Registry, the Dutch Institute for Clinical Auditing foundation received a start-up grant from governmental organisation The Netherlands Organization for Health Research and Development (ZonMW, project number 836002002). The DMTR is structurally funded by Bristol-Myers Squibb, Merck Sharpe \& Dohme, Novartis and Roche Pharma. Roche Pharma stopped funding in 2019 and Pierre Fabre started funding of the DMTR in 2019. For this work no funding was granted. Publisher Copyright: {\textcopyright} 2020 Elsevier Ltd",

year = "2021",

month = feb,

day = "1",

doi = "10.1016/j.ejca.2020.11.028",

language = "English",

volume = "144",

pages = "242--251",

journal = "European Journal of Cancer",

issn = "0959-8049",

publisher = "Elsevier Ltd",

}

van Zeijl, MCT, de Wreede, LC, van den Eertwegh, AJM, Wouters, MWJM, Jochems, A, Schouwenburg, MG, Aarts, MJB, van Akkooi, ACJ, van den Berkmortel, FWPJ, de Groot, JWB, Hospers, GAP, Kapiteijn, E, Piersma, D, van Rijn, RS, Suijkerbuijk, KPM, Ten Tije, AJ, van der Veldt, AAM, Vreugdenhil, G, van der Hoeven, JJM & Haanen, JBAG 2021, 'Survival outcomes of patients with advanced melanoma from 2013 to 2017: Results of a nationwide population-based registry', European Journal of Cancer, vol. 144, pp. 242-251. https://doi.org/10.1016/j.ejca.2020.11.028

TY - JOUR

T1 - Survival outcomes of patients with advanced melanoma from 2013 to 2017: Results of a nationwide population-based registry

AU - van Zeijl, M.C.T.

AU - de Wreede, L.C.

AU - van den Eertwegh, A.J.M.

AU - Wouters, M.W.J.M.

AU - Jochems, A.

AU - Schouwenburg, M.G.

AU - Aarts, M.J.B.

AU - van Akkooi, A.C.J.

AU - van den Berkmortel, F.W.P.J.

AU - de Groot, J.W.B.

AU - Hospers, G.A.P.

AU - Kapiteijn, E.

AU - Piersma, D.

AU - van Rijn, R.S.

AU - Suijkerbuijk, K.P.M.

AU - Ten Tije, A.J.

AU - van der Veldt, A.A.M.

AU - Vreugdenhil, G.

AU - van der Hoeven, J.J.M.

AU - Haanen, J.B.A.G.

N1 - Funding Information: For the Dutch Melanoma Treatment Registry, the Dutch Institute for Clinical Auditing foundation received a start-up grant from governmental organisation The Netherlands Organization for Health Research and Development (ZonMW, project number 836002002). The DMTR is structurally funded by Bristol-Myers Squibb , Merck Sharpe & Dohme, Novartis and Roche Pharma. Roche Pharma stopped funding in 2019 and Pierre Fabre started funding of the DMTR in 2019. For this work no funding was granted. Funding Information: For the Dutch Melanoma Treatment Registry, the Dutch Institute for Clinical Auditing foundation received a start-up grant from governmental organisation The Netherlands Organization for Health Research and Development (ZonMW, project number 836002002). The DMTR is structurally funded by Bristol-Myers Squibb, Merck Sharpe & Dohme, Novartis and Roche Pharma. Roche Pharma stopped funding in 2019 and Pierre Fabre started funding of the DMTR in 2019. For this work no funding was granted. Publisher Copyright: © 2020 Elsevier Ltd

PY - 2021/2/1

Y1 - 2021/2/1

N2 - Background: The treatment landscape has completely changed for advanced melanoma. We report survival outcomes and the differential impact of prognostic factors over time in daily clinical practice.Methods: From a Dutch nationwide population-based registry, patients with advanced melanoma diagnosed from 2013 to 2017 were analysed (n = 3616). Because the proportional hazards assumption was violated, a multivariable Cox model restricted to the first 6 months and a multivariable landmark Cox model from 6 to 48 months were used to assess overall survival (OS) of cases without missing values. The 2017 cohort was excluded from this analysis because of the short follow-up time.Results: Median OS of the 2013 and 2016 cohort was 11.7 months (95% confidence interval [CI]: 10.4-13.5) and 17.7 months (95% CI: 14.9-19.8), respectively. Compared with the 2013 cohort, the 2016 cohort had superior survival in the Cox model from 0 to 6 months (hazard ratio [HR] = 0.55 [95% CI: 0.43-0.72]) and in the Cox model from 6 to 48 months (HR = 0.68 [95% CI: 0.57-0.83]). Elevated lactate dehydrogenase levels, distant metastases in >= 3 organ sites, brain and liver metastasis and Eastern Cooperative Oncology Group performance score of >= 1 had stronger association with inferior survival from 0 to 6 months than from 6 to 48 months. BRAF-mutated melanoma had superior survival in the first 6 months (HR = 0.50 [95% CI: 0.42-0.59]).Conclusion(s): Prognosis for advanced melanoma in the Netherlands has improved from 2013 to 2016. Prognostic importance of most evaluated factors was higher in the first 6 months after diagnosis. BRAF-mutated melanoma was only associated with superior survival in the first 6 months. (C) 2020 Elsevier Ltd. All rights reserved.

AB - Background: The treatment landscape has completely changed for advanced melanoma. We report survival outcomes and the differential impact of prognostic factors over time in daily clinical practice.Methods: From a Dutch nationwide population-based registry, patients with advanced melanoma diagnosed from 2013 to 2017 were analysed (n = 3616). Because the proportional hazards assumption was violated, a multivariable Cox model restricted to the first 6 months and a multivariable landmark Cox model from 6 to 48 months were used to assess overall survival (OS) of cases without missing values. The 2017 cohort was excluded from this analysis because of the short follow-up time.Results: Median OS of the 2013 and 2016 cohort was 11.7 months (95% confidence interval [CI]: 10.4-13.5) and 17.7 months (95% CI: 14.9-19.8), respectively. Compared with the 2013 cohort, the 2016 cohort had superior survival in the Cox model from 0 to 6 months (hazard ratio [HR] = 0.55 [95% CI: 0.43-0.72]) and in the Cox model from 6 to 48 months (HR = 0.68 [95% CI: 0.57-0.83]). Elevated lactate dehydrogenase levels, distant metastases in >= 3 organ sites, brain and liver metastasis and Eastern Cooperative Oncology Group performance score of >= 1 had stronger association with inferior survival from 0 to 6 months than from 6 to 48 months. BRAF-mutated melanoma had superior survival in the first 6 months (HR = 0.50 [95% CI: 0.42-0.59]).Conclusion(s): Prognosis for advanced melanoma in the Netherlands has improved from 2013 to 2016. Prognostic importance of most evaluated factors was higher in the first 6 months after diagnosis. BRAF-mutated melanoma was only associated with superior survival in the first 6 months. (C) 2020 Elsevier Ltd. All rights reserved.

KW - advanced melanoma

KW - combined nivolumab

KW - double-blind

KW - immunotherapy

KW - ipilimumab

KW - iv melanoma

KW - metastatic melanoma

KW - nationwide

KW - pembrolizumab

KW - phase-iii trials

KW - pooled analysis

KW - population-based

KW - progression-free

KW - real-world

KW - targeted therapy

KW - vemurafenib

KW - Targeted therapy

KW - Real-world

KW - Advanced melanoma

KW - Nationwide

KW - METASTATIC MELANOMA

KW - Population-based

KW - Immunotherapy

KW - IV MELANOMA

KW - POOLED ANALYSIS

KW - VEMURAFENIB

KW - COMBINED NIVOLUMAB

KW - PEMBROLIZUMAB

KW - DOUBLE-BLIND

KW - PROGRESSION-FREE

KW - PHASE-III TRIALS

KW - IPILIMUMAB

U2 - 10.1016/j.ejca.2020.11.028

DO - 10.1016/j.ejca.2020.11.028

M3 - Article

C2 - 33373869

SN - 0959-8049

VL - 144

SP - 242

EP - 251

JO - European Journal of Cancer

JF - European Journal of Cancer

ER -

Survival outcomes of patients with advanced melanoma from 2013 to 2017: Results of a nationwide population-based registry

Abstract

Keywords

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