Cost-Benefit Implication of Gene Expression Profiling and Adjuvant Therapy in Stage IIIA Melanoma

Hu, Yinin; Briggs, Andrew; Marchetti, Michael A.; Ariyan, Charlotte E.; Coit, Daniel G.; Bartlett, Edmund K.

doi:10.1016/j.jamcollsurg.2020.08.750

Cited by 9 publications

(3 citation statements)

References 22 publications

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“…If all BRAF wild type stage IIIA patients were to be treated with pembrolizumab 200 mg every 3 weeks, the estimated 10-year cost per avoided death is ~2.44 million US dollars, that is, an incremental cost per additional life-year of ~697,100 US dollars. 13,23 As previously described, the management of stage IIImelanoma is quite heterogenous in France, which might result in a polarization of practices and in multiplied centre effects across the territory. Furthermore, the lack of standardization in the treatment of stage III melanoma does not appear to be cost-effective and could be responsible for additional health costs.…”

Section: Discussionmentioning

confidence: 99%

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French dermatologists' opinions and practices with regard to adjuvant therapy in stage III melanoma

Rolland

Oger

Dinulescu

et al. 2023

JEADV Clinical Practice

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BackgroundIn 2018, the European Medicines Agency authorized adjuvant therapy for patients with resected stage III melanoma.ObjectivesThe objective of the present study (performed in France) was to assess dermatologists' and oncologists' opinions and prescribing habits in this context.MethodsFrom 28 May to 8 June 2021, we performed an online survey of members of the French Groupe de Cancérologie Cutanée (GCC) skin cancer interest group.ResultsThirty‐eight practitioners replied to the survey. For BRAF‐mutant melanoma, 58% of the practitioners favoured immunotherapy (IT). If they themselves were to suffer from melanoma with a BRAFV600 mutation, 65% would choose IT for stage IIIB disease, and 72% would choose IT for stage IIID disease. For stage IIIA melanoma with a positive sentinel lymphatic node (SLN) biopsy <1 mm, 32% of the practitioners stated that they would not offer adjuvant therapy. Sixty‐three percent of the practitioners disagreed with restricting adjuvant therapy to patients aged 80 and over. Although 84% of the practitioners were aware of the cost of adjuvant therapy, 81% did not take account of this factor in their treatment decisions. In patients with a positive SLN biopsy, 90% of the practitioners stated that they would not recommend complete lymph node dissection. Eighty percent of the surveyed practitioners discussed the potential impact of treatments on fertility, respectively with their male and female patients. Of these practitioners, 63%–72% (depending on the situation) stated that they would recommend fertility preservation procedures.ConclusionsThis work points out some debated issues among French dermatologists and oncologists regarding adjuvant therapy in stage III melanoma. Our present results might prompt more comprehensive studies of these particular points.

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Section: Discussionmentioning

confidence: 99%

“…The cost of adjuvant therapy is also an issue that requires attention. If all BRAF wild type stage IIIA patients were to be treated with pembrolizumab 200 mg every 3 weeks, the estimated 10‐year cost per avoided death is ~2.44 million US dollars, that is, an incremental cost per additional life‐year of ~697,100 US dollars 13,23 …”

Section: Discussionmentioning

confidence: 99%

French dermatologists' opinions and practices with regard to adjuvant therapy in stage III melanoma

Rolland

Oger

Dinulescu

et al. 2023

JEADV Clinical Practice

View full text Add to dashboard Cite

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“…A meta-analysis reported that 31-GEP performance varied, and was a better predictor of recurrence in stage II disease than in stage I [33]. However, a separate study suggested that there is limited cost-benefit of 31-GEP utilization in stage IIIA melanoma due to the limited survival benefit of this tool for this patient subgroup [34]. Given the lack of clear evidence that 31-GEP improves outcomes in melanoma, an established prognostic tool is still needed to accurately identify high-risk patients.…”

Section: Gene-expression Profilingmentioning

confidence: 99%

Bioinformatic and Machine Learning Applications in Melanoma Risk Assessment and Prognosis: A Literature Review

Hoegler

Zhou

2021

Genes

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Over 100,000 people are diagnosed with cutaneous melanoma each year in the United States. Despite recent advancements in metastatic melanoma treatment, such as immunotherapy, there are still over 7000 melanoma-related deaths each year. Melanoma is a highly heterogenous disease, and many underlying genetic drivers have been identified since the introduction of next-generation sequencing. Despite clinical staging guidelines, the prognosis of metastatic melanoma is variable and difficult to predict. Bioinformatic and machine learning analyses relying on genetic, clinical, and histopathologic inputs have been increasingly used to risk stratify melanoma patients with high accuracy. This literature review summarizes the key genetic drivers of melanoma and recent applications of bioinformatic and machine learning models in the risk stratification of melanoma patients. A robustly validated risk stratification tool can potentially guide the physician management of melanoma patients and ultimately improve patient outcomes.

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Impact of the changes in the completion lymph node dissection criteria and approval of adjuvant therapies on the real-world outcomes of Japanese stage III melanoma patients

Ogata¹,

Tanese

Nakamura

et al. 2021

Int J Clin Oncol

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Cost-Benefit Implication of Gene Expression Profiling and Adjuvant Therapy in Stage IIIA Melanoma

Cited by 9 publications

References 22 publications

French dermatologists' opinions and practices with regard to adjuvant therapy in stage III melanoma

French dermatologists' opinions and practices with regard to adjuvant therapy in stage III melanoma

Bioinformatic and Machine Learning Applications in Melanoma Risk Assessment and Prognosis: A Literature Review

Impact of the changes in the completion lymph node dissection criteria and approval of adjuvant therapies on the real-world outcomes of Japanese stage III melanoma patients

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