TY - JOUR
T1 - Survival outcomes of patients with advanced mucosal melanoma diagnosed from 2013 to 2017 in the Netherlands - A nationwide population-based study
AU - van Zeijl, Michiel C. T.
AU - Boer, Florine L.
AU - van Poelgeest, Mariette I. E.
AU - van den Eertwegh, Alfons J. M.
AU - Wouters, Michel W. J. M.
AU - de Wreede, Liesbeth C.
AU - Aarts, Maureen J. B.
AU - van den Berkmortel, Franchette W. P. J.
AU - de Groot, Jan Willem B.
AU - Hospers, Geke A. P.
AU - Piersma, Djura
AU - van Rijn, Rozemarijn S.
AU - Suijkerbuijk, Karijn P. M.
AU - ten Tije, Albert J.
AU - van der Veldt, Astrid A. M.
AU - Vreugdenhil, Gerard
AU - Boers-Sonderen, Marye J.
AU - Kapiteijn, Ellen H. W.
AU - Haanen, John B. A. G.
N1 - Funding Information:
The Dutch Institute for Clinical Auditing foundation received a start-up grant for the Dutch Melanoma Treatment Registry (DMTR) 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 - 2020/9
Y1 - 2020/9
N2 - Background: Mucosal melanoma (MM) is rare and has a poor prognosis. Since 2011, new effective treatments are available for advanced melanoma. It is unclear whether patients with mucosal melanoma equally benefit from these new treatments compared with patients with cutaneous melanoma (CM).Methods: Patients with advanced MM and CM diagnosed between 2013 and 2017 were included from a nationwide population-based registry the Dutch Melanoma Treatment Registry. Overall survival (OS) was estimated with the Kaplan-Meier method (also for a propensity score-matched cohort). A Cox model was used to analyse the association of possible prognostic factors with OS.Results: In total, 120 patients with MM and 2960 patients with CM were included. Median OS was 8.7 months and 14.5 months, respectively. Patients with MM were older (median age 70 versus 65 years) and more often female (60% versus 41%), compared with CM. In total, 77% and 2% of the MM patients were treated with first-line immunotherapy and targeted therapy, respectively, compared with 49% and 33% of the CM patients. In contrast to CM, OS for MM did not improve for patients diagnosed in 2015-2017, compared with 2013-2014. ECOG performance score >= 1 (HR = 1.99 [1.26-3.15; p = 0.003]) and elevated LDH level (HR = 1.63 [0.96-2.76]; p = 0.069) in MM were associated with worse survival.Conclusions: Within the era of immune and targeted therapies, prognosis for patients with advanced MM has not improved as much as for CM. Collaboration is necessary to enlarge sample size for research to improve immunotherapeutic strategies and identify targetable mutations. (C) 2020 Elsevier Ltd. All rights reserved.
AB - Background: Mucosal melanoma (MM) is rare and has a poor prognosis. Since 2011, new effective treatments are available for advanced melanoma. It is unclear whether patients with mucosal melanoma equally benefit from these new treatments compared with patients with cutaneous melanoma (CM).Methods: Patients with advanced MM and CM diagnosed between 2013 and 2017 were included from a nationwide population-based registry the Dutch Melanoma Treatment Registry. Overall survival (OS) was estimated with the Kaplan-Meier method (also for a propensity score-matched cohort). A Cox model was used to analyse the association of possible prognostic factors with OS.Results: In total, 120 patients with MM and 2960 patients with CM were included. Median OS was 8.7 months and 14.5 months, respectively. Patients with MM were older (median age 70 versus 65 years) and more often female (60% versus 41%), compared with CM. In total, 77% and 2% of the MM patients were treated with first-line immunotherapy and targeted therapy, respectively, compared with 49% and 33% of the CM patients. In contrast to CM, OS for MM did not improve for patients diagnosed in 2015-2017, compared with 2013-2014. ECOG performance score >= 1 (HR = 1.99 [1.26-3.15; p = 0.003]) and elevated LDH level (HR = 1.63 [0.96-2.76]; p = 0.069) in MM were associated with worse survival.Conclusions: Within the era of immune and targeted therapies, prognosis for patients with advanced MM has not improved as much as for CM. Collaboration is necessary to enlarge sample size for research to improve immunotherapeutic strategies and identify targetable mutations. (C) 2020 Elsevier Ltd. All rights reserved.
KW - Mucosal melanoma
KW - Advanced disease
KW - Prognostic factors
KW - Survival
KW - Immunotherapy
KW - PHASE-II
KW - METASTATIC MELANOMA
KW - PROGNOSTIC-FACTORS
KW - POOLED ANALYSIS
KW - DOUBLE-BLIND
KW - IPILIMUMAB
KW - EFFICACY
KW - SAFETY
KW - NIVOLUMAB
KW - PATTERNS
U2 - 10.1016/j.ejca.2020.05.021
DO - 10.1016/j.ejca.2020.05.021
M3 - Article
C2 - 32763783
SN - 0959-8049
VL - 137
SP - 127
EP - 135
JO - European Journal of Cancer
JF - European Journal of Cancer
ER -