Advanced melanoma is a life‐threatening cancer with limited life expectancy. The recent introduction of new targeted systemic therapies has provided clinicians with the means to potentially extend survival for the first time. However, the chance of cure remains very low and treatment‐induced toxicity is well described. This qualitative study was undertaken to evaluate clinicians’ assessment regarding the key concerns in managing advanced melanoma following the introduction of these new treatments. Three hundred and forty‐three oncologists were surveyed online between August and November 2012 (in 11 countries) and March and April 2013 (in an additional country). Analysis of free‐text responses identified 23 clinical issues of concern across all countries. Of these, the most common clinical concerns were drug toxicity and tolerability, followed by limited treatment effectiveness and limited treatment options. These results suggest that despite the promise of the two new agents in the field, clinicians are still concerned about the limitations of current treatment options, recognising that there remains a significant unmet need in the treatment of advanced melanoma.

A237primary target for drug-seeking patients, this pilot study was conducted to validate a survey instrument designed to assess emergency physicians (EPs) intention to use the recently available Texas PMP. Methods: A cross-sectional survey of EPs was conducted at a statewide emergency medicine conference. A 34-item questionnaire, based on the Technology Acceptance Model (TAM), was developed to assess EPs intention to use the Texas PMP. Items related to technology acceptance (perceived ease of use, perceived usefulness, attitude, and intention) were assessed using 5-point Likert scale responses (1= strongly disagree to 5= strongly agree). The survey expanded on a previous exploratory survey of EPs. Correlation analyses were used to validate the survey instrument scales. Results: Of the 45 respondents, most were male (68.9%), attending EPs (57.8%), with 10.8±11.1 years in emergency medicine, from a community hospital setting (55.6%), and were users of the Texas PMP (51.2%). Among those who were not registered, 39.2% reported lack of awareness as the primary reason for not being registered. Standardized Cronbach's alphas for the constructs of perceived ease of use, perceived usefulness, attitude, and intention for PMP users were 0.88, 0.90, 0.74, and 0.84, respectively; and 0.77, 0.87, 0.84, and 0.74, respectively for PMP non-users. ConClusions: Considering the ED as a source of diversion, it is important to understand EPs utilization of PMPs. EPs use of PMPs may help to mitigate the economic burden associated with the non-medical use of prescription opioids, while improving patient outcomes. Future studies using this survey instrument are needed to further assess the predictive utility.

e20014 Background: Since 2011, two therapies that provide novel approaches to the treatment of advanced (unresectable or metastatic) melanoma have been introduced to the market: ipilimumab for second line and vemurafenib for BRAF mutation-positive melanoma. It is not known how the new drugs influence treatment; this study investigated current treatment patterns in advanced melanoma. Methods: A clinician-validated, web-based survey was administered between August and November 2012 to clinicians who treat advanced melanoma in France, Germany, Italy, Spain, and the UK. Respondents were asked about their treatment of patients in the previous 12 months, including treatment modalities and pharmaceutical therapies used, and factors that affect treatment choice. Results: 150 oncologists and dermatologists completed the survey, 30 in each country. Pharmaceutical therapy was more commonly used than other treatment modalities and varied by stage of disease. A high proportion of patients with late stage of disease were treated with pharmaceutical therapy in Germany (85% in M1B) and France (83% in M1C). Among the countries, 51% (Italy) to 87% (France) of respondents test BRAF mutation status. In patients with wild-type BRAF tumors, dacarbazine, which has not been shown to provide any overall survival benefit, was the most commonly used drug for first-line therapy in all countries. In mutated BRAF tumors, vemurafenib was the most commonly used drug in first line therapy in 3 of 5 countries. There was no standard of care in second line for either patients with wild-type or mutated-BRAFtumors; therapies used included fotemustine, temozolomide, interferon, paclitaxel, and ipilimumab. Conclusions: Treatment options for patients with advanced melanoma are limited, particularly for patients with wild-type BRAF disease. In second line, there does not appear to be an established standard of care: a range of treatments are used, including several not indicated for melanoma.