Treatment patterns in advanced melanoma: findings from a survey of European oncologists

Abstract

With the emergence of new therapies, established patterns of treating advanced melanoma are changing. The aim of this study was to understand how advanced melanoma is treated in clinical practice in Europe following the introduction of ipilimumab and vemurafenib. An online survey was conducted between August and November 2012 with 150 oncologists and dermatologists, from France, Germany, Italy, Spain and the U.K.; respondents reported treating the majority of patients with one or two lines of therapy. For BRAF mutant melanoma, the most frequently used first-line treatments were vemurafenib and dacarbazine. For BRAF wild-type melanoma, the most frequently used first-line treatment was dacarbazine. There was no single preferred agent for the second-line treatment of BRAF mutant or BRAF wild-type disease. Most sequencing from first- to second-line was from conventional dacarbazine to newer agents such as ipilimumab and vemurafenib. The treatment of advanced melanoma is rapidly evolving due to the introduction of new agents. This study presents an early insight into access to the new agents, ipilimumab and vemurafenib, and clinical practice in several European countries.

<p>Treatment of Advanced/Metastatic Melanoma in the United States and Western Europe: Results of the CancerMPact Survey</p>

“…1,3,7 Overall, the results of this survey show that interviewed physicians are aligned with this fact, with IO or targeted therapies making up over 70% of the treatments prescribed by physicians as the first-line treatment for advanced melanoma patients, a remarkable evolution from five years ago. 10 These new treatments (IO and targeted therapy) are well tolerated, but this benefit comes with what has been Notes: $ Other chemotherapy includes many different schemes, with dacarbazine, interferon, interleukin, vinblastine, paclitaxel, carboplatin, alone in combined; excludes combinations with newer immunotherapies (pembrolizumab, nivolumab, ipilimumab etc) and targeted therapy. # CVDcisplatin, vinblastine, dacarbazine.…”

“… 1 , 3 , 7 Overall, the results of this survey show that interviewed physicians are aligned with this fact, with IO or targeted therapies making up over 70% of the treatments prescribed by physicians as the first-line treatment for advanced melanoma patients, a remarkable evolution from five years ago. 10 …”

Relative Efficacy of Granulocyte-Macrophage Colony-Stimulating Factor, Dacarbazine, and Glycoprotein 100 in Metastatic Melanoma: An Indirect Treatment Comparison

“…The treatment landscape for metastatic melanoma has evolved rapidly in recent years. Evidence of significant survival benefits from randomized controlled phase 3 trials means that immunotherapies and targeted agents are now treatment options for a patient population that historically has been considered difficult to treat [ 4 , 5 , 23 ]. There are challenges in estimating the relative treatment effects of new therapies, however, because they were compared to different older agents in pivotal phase 3 trials and the relative efficacy of these older agents has never been established.…”

Indirect Treatment Comparison of Talimogene Laherparepvec Compared with Ipilimumab and Vemurafenib for the Treatment of Patients with Metastatic Melanoma

“…Until 2011, the only systemic therapies for metastatic melanoma were conventional agents, such as dacarbazine, fotemustine, and interleukin-2 [ 3 , 4 ], that did not show clinically meaningful improvements in OS. Recently licensed agents include ipilimumab, vemurafenib, dabrafenib, trametinib, pembrolizumab, and nivolumab, which have all been approved by the US Food and Drug Administration (FDA) and the European Medicines Agency (EMA).…”