LB957 Skin cancer recognition for whole slide histology images with state-of-the-art Convolutional Neural Networks

Abstract

Treatment adherence can be impacted by several factors, including route of administration, dosing schedule, and pt perceptions. This study assessed pt-reported adherence and associated barriers in pts with melanoma treated with adjuvant therapy. Adult pts with resected stage 3/4 melanoma with no evidence of disease were recruited by a pt panel and the Melanoma Research Foundation to participate in an online survey. Pts were required to have received adjuvant therapy with nivolumab or pembrolizumab (intravenous [IV] cohort) or dabrafenib+trametinib (oral cohort). Adherence was estimated using self-reported overall number of infusions missed for the IV cohort and self-reported adherence level in the past 2 months for the oral cohort. Of 184 eligible pts (127 IV, 57 oral), mean age was 45 years, 44% were female, and 78% were white. Most pts were engaged in treatment decision-making (86%) and considered their well-being to be "good" (46%), "very good" (26%), or "excellent" (9%). Compared with the oral cohort, more pts in the IV cohort were employed full time (67% vs 47%; P¼0.012) and had commercial insurance (76% vs 47%; P<0.001). Mean time on the current adjuvant treatment was similar between the IV (8.3 months) and oral (7.7 months) cohorts. Adherence was relatively high, with pts following their regimens always (81% IV, 58% oral; P¼0.002) or almost all of the time (17% IV, 33% oral; P¼0.002). Nonadherence behavior was lower in the IV cohort than in the oral cohort (19% vs 42%; P<0.001), with forgetfulness (54% vs 46%), affordability (0% vs 46%; P<0.001), and safety concerns (29% vs 42%) listed as common reasons for nonadherence. Many pts did not expect to follow future regimens as instructed (37% IV, 46% oral), primarily due to affordability and safety concerns, which were similar in both cohorts. This study found that pt-reported adherence to adjuvant therapy was relatively high among those with advanced resectable melanoma but also presented potential areas for further improvement.