Survival outcomes of patients with advanced melanoma from 2013 to 2017: Results of a nationwide population-based registry

M C T van Zeijl¹, L C de Wreede², A J M van den Eertwegh³, M W J M Wouters⁴, A Jochems⁵, M G Schouwenburg⁶, M J B Aarts⁷, A C J van Akkooi⁸, F W P J van den Berkmortel⁹, J W B de Groot¹⁰, G A P Hospers¹¹, E Kapiteijn¹², D Piersma¹³, R S van Rijn¹⁴, K P M Suijkerbuijk¹⁵, A J Ten Tije¹⁶, A A M van der Veldt¹⁷, G Vreugdenhil¹⁸, J J M van der Hoeven¹⁹, J B A G Haanen²⁰

Affiliations

¹ Dutch Institute for Clinical Auditing, Rijnsburgerweg 10, Leiden, 2333AA, the Netherlands; Department of Medical Oncology, Leiden University Medical Center, Albinusdreef 2, Leiden, 2333ZA, the Netherlands.
² Department of Biomedical Data Sciences, Leiden University Medical Center, Einthovenweg 20, Leiden, 2333ZC, the Netherlands.
³ Department of Medical Oncology, Amsterdam UMC, Location VU Medical Center (VUmc), Cancer Center Amsterdam, De Boelelaan 1117, Amsterdam, 1081 HV, the Netherlands.
⁴ Dutch Institute for Clinical Auditing, Rijnsburgerweg 10, Leiden, 2333AA, the Netherlands; Department of Surgical Oncology, The Netherlands Cancer Institute, Plesmanlaan 121, Amsterdam, 1066CX, the Netherlands.
⁵ Dutch Institute for Clinical Auditing, Rijnsburgerweg 10, Leiden, 2333AA, the Netherlands; Department of Medical Oncology, Haaglanden Medisch Centrum, Lijnbaan 32, Den Haag, 2512VA, the Netherlands.
⁶ Dutch Institute for Clinical Auditing, Rijnsburgerweg 10, Leiden, 2333AA, the Netherlands.
⁷ Department of Medical Oncology, Maastricht University Medical Center, P. Debyelaan 25, Maastricht, 6229 HX, the Netherlands.
⁸ Department of Surgical Oncology, The Netherlands Cancer Institute, Plesmanlaan 121, Amsterdam, 1066CX, the Netherlands.
⁹ Department of Medical Oncology, Zuyderland Medical Center, Dr. H. van der Hoffplein 1, Sittard-Geleen, 6162BG, the Netherlands.
¹⁰ Department of Medical Oncology, Isala Clinics, Dokter van Heesweg 2, Zwolle, 8025AB, the Netherlands.
¹¹ Department of Medical Oncology, University Medical Center Groningen, Hanzeplein 1, Groningen, 9713GZ, the Netherlands.
¹² Department of Medical Oncology, Leiden University Medical Center, Albinusdreef 2, Leiden, 2333ZA, the Netherlands.
¹³ Department of Internal Medicine, Medisch Spectrum Twente, Koningsplein 1, Enschede, 7512KZ, the Netherlands.
¹⁴ Department of Internal Medicine, Medical Center Leeuwarden, Henri Dunantweg 2, Leeuwarden, 8934AD, the Netherlands.
¹⁵ Department of Medical Oncology, University Medical Center Utrecht, Cancer Center, Heidelberglaan 100, Utrecht, 3584CX, the Netherlands.
¹⁶ Department of Internal Medicine, Amphia Hospital, Molengracht 21, Breda, 4818CK, the Netherlands.
¹⁷ Department of Medical Oncology, Erasmus MC Cancer Institute, 's-Gravendijkwal 230, Rotterdam, 3015CE, the Netherlands.
¹⁸ Department of Internal Medicine, Maxima Medical Center, De Run 4600, Eindhoven, 5504DB, the Netherlands.
¹⁹ Department of Medical Oncology, Radboudumc, Geert Grooteplein Zuid 10, Nijmegen, 6525GA, the Netherlands.
²⁰ Divisions of Medical Oncology and Molecular Oncology & Immunology, the Netherlands Cancer Institute, Plesmanlaan 121, Amsterdam, 1066CX, the Netherlands. Electronic address: j.haanen@nki.nl.

PMID: 33373869
DOI: 10.1016/j.ejca.2020.11.028

Survival outcomes of patients with advanced melanoma from 2013 to 2017: Results of a nationwide population-based registry

M C T van Zeijl et al. Eur J Cancer. 2021 Feb.

. 2021 Feb:144:242-251.

doi: 10.1016/j.ejca.2020.11.028. Epub 2020 Dec 26.

Authors

Affiliations

¹ Dutch Institute for Clinical Auditing, Rijnsburgerweg 10, Leiden, 2333AA, the Netherlands; Department of Medical Oncology, Leiden University Medical Center, Albinusdreef 2, Leiden, 2333ZA, the Netherlands.
² Department of Biomedical Data Sciences, Leiden University Medical Center, Einthovenweg 20, Leiden, 2333ZC, the Netherlands.
³ Department of Medical Oncology, Amsterdam UMC, Location VU Medical Center (VUmc), Cancer Center Amsterdam, De Boelelaan 1117, Amsterdam, 1081 HV, the Netherlands.
⁴ Dutch Institute for Clinical Auditing, Rijnsburgerweg 10, Leiden, 2333AA, the Netherlands; Department of Surgical Oncology, The Netherlands Cancer Institute, Plesmanlaan 121, Amsterdam, 1066CX, the Netherlands.
⁵ Dutch Institute for Clinical Auditing, Rijnsburgerweg 10, Leiden, 2333AA, the Netherlands; Department of Medical Oncology, Haaglanden Medisch Centrum, Lijnbaan 32, Den Haag, 2512VA, the Netherlands.
⁶ Dutch Institute for Clinical Auditing, Rijnsburgerweg 10, Leiden, 2333AA, the Netherlands.
⁷ Department of Medical Oncology, Maastricht University Medical Center, P. Debyelaan 25, Maastricht, 6229 HX, the Netherlands.
⁸ Department of Surgical Oncology, The Netherlands Cancer Institute, Plesmanlaan 121, Amsterdam, 1066CX, the Netherlands.
⁹ Department of Medical Oncology, Zuyderland Medical Center, Dr. H. van der Hoffplein 1, Sittard-Geleen, 6162BG, the Netherlands.
¹⁰ Department of Medical Oncology, Isala Clinics, Dokter van Heesweg 2, Zwolle, 8025AB, the Netherlands.
¹¹ Department of Medical Oncology, University Medical Center Groningen, Hanzeplein 1, Groningen, 9713GZ, the Netherlands.
¹² Department of Medical Oncology, Leiden University Medical Center, Albinusdreef 2, Leiden, 2333ZA, the Netherlands.
¹³ Department of Internal Medicine, Medisch Spectrum Twente, Koningsplein 1, Enschede, 7512KZ, the Netherlands.
¹⁴ Department of Internal Medicine, Medical Center Leeuwarden, Henri Dunantweg 2, Leeuwarden, 8934AD, the Netherlands.
¹⁵ Department of Medical Oncology, University Medical Center Utrecht, Cancer Center, Heidelberglaan 100, Utrecht, 3584CX, the Netherlands.
¹⁶ Department of Internal Medicine, Amphia Hospital, Molengracht 21, Breda, 4818CK, the Netherlands.
¹⁷ Department of Medical Oncology, Erasmus MC Cancer Institute, 's-Gravendijkwal 230, Rotterdam, 3015CE, the Netherlands.
¹⁸ Department of Internal Medicine, Maxima Medical Center, De Run 4600, Eindhoven, 5504DB, the Netherlands.
¹⁹ Department of Medical Oncology, Radboudumc, Geert Grooteplein Zuid 10, Nijmegen, 6525GA, the Netherlands.
²⁰ Divisions of Medical Oncology and Molecular Oncology & Immunology, the Netherlands Cancer Institute, Plesmanlaan 121, Amsterdam, 1066CX, the Netherlands. Electronic address: j.haanen@nki.nl.

PMID: 33373869
DOI: 10.1016/j.ejca.2020.11.028

Abstract

Background: The treatment landscape has completely changed for advanced melanoma. We report survival outcomes and the differential impact of prognostic factors over time in daily clinical practice.

Methods: From a Dutch nationwide population-based registry, patients with advanced melanoma diagnosed from 2013 to 2017 were analysed (n = 3616). Because the proportional hazards assumption was violated, a multivariable Cox model restricted to the first 6 months and a multivariable landmark Cox model from 6 to 48 months were used to assess overall survival (OS) of cases without missing values. The 2017 cohort was excluded from this analysis because of the short follow-up time.

Results: Median OS of the 2013 and 2016 cohort was 11.7 months (95% confidence interval [CI]: 10.4-13.5) and 17.7 months (95% CI: 14.9-19.8), respectively. Compared with the 2013 cohort, the 2016 cohort had superior survival in the Cox model from 0 to 6 months (hazard ratio [HR] = 0.55 [95% CI: 0.43-0.72]) and in the Cox model from 6 to 48 months (HR = 0.68 [95% CI: 0.57-0.83]). Elevated lactate dehydrogenase levels, distant metastases in ≥3 organ sites, brain and liver metastasis and Eastern Cooperative Oncology Group performance score of ≥1 had stronger association with inferior survival from 0 to 6 months than from 6 to 48 months. BRAF-mutated melanoma had superior survival in the first 6 months (HR = 0.50 [95% CI: 0.42-0.59]).

Conclusion(s): Prognosis for advanced melanoma in the Netherlands has improved from 2013 to 2016. Prognostic importance of most evaluated factors was higher in the first 6 months after diagnosis. BRAF-mutated melanoma was only associated with superior survival in the first 6 months.

Keywords: Advanced melanoma; Immunotherapy; Nationwide; Population-based; Real-world; Targeted therapy.

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Conflict of interest statement

Conflict of interest statement AvdE reports advisory relationships with Amgen, Bristol-Myers Squibb, Roche, Novartis, MSD, and Pierre-Fabre. AvA reports consultancy/advisory relationships with Amgen, Bristol-Myers Squibb, Novartis, MSD-Merck, Merck-Pfizer, and 4SC and research grants not related to this paper from Amgen, BMS, and Novartis. JdG reports personal fees outside the submitted work from Bristol-Myers Squibb, Roche, Pierre-Fabre, Servier, and MSD, Novartis. GH reports consultancy/advisory relationships with Amgen, Bristol-Myers Squibb, Roche, MSD, Pfizer, and Novartis and research grants not related to this paper from Bristol-Myers Squibb, and Seerave. EK has consultancy/advisory relationships with Amgen, Bristol-Myers Squibb, Novartis, Roche, Merck, Pierre-Fabre, EISAI, Bayer, and Genzyme-Sanofi and research grants not related to this paper from Novartis and Bristol-Myers Squibb. KS advisory relationships with Bristol-Myers Squibb, Roche, Novartis, MSD, and Pierre-Fabre. AvdV reports consultancy relationships with Bristol-Myers Squibb, MSD, Roche, Novartis, Pierre-Fabre, Pfizer, Sanofi, Ipsen, and Eisai. JH reports advisory relationships with Amgen, AstraZeneca, Bayer, Bristol-Myers Squibb, Celsius Therapeutics, GSK, Immunocore, Ipsen, MSD, Merck Serono, Novartis, Neon Therapeutics, Pfizer, Roche/Genentech, Sanofi, and Seattle Genetics and research grants not related to this paper from Novartis, Bristol-Myers Squibb, MSD, and Neon Therapeutics. All grants were paid to the institutions. The funders had no role in the writing of this article or decision to submit it for publication.

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Survival outcomes of patients with advanced melanoma from 2013 to 2017: Results of a nationwide population-based registry

Affiliations

Survival outcomes of patients with advanced melanoma from 2013 to 2017: Results of a nationwide population-based registry

Authors

Affiliations

Abstract

Conflict of interest statement

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LinkOut - more resources

Full Text Sources

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Medical

Research Materials