Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Nov;30(11):9587-9596.
doi: 10.1007/s00520-022-07360-4. Epub 2022 Sep 22.

Feasibility, acceptability, and utility of a nurse-led survivorship program for people with metastatic melanoma (MELCARE)

Julia Lai-Kwon  1 , Brooke Kelly  2 , Sarah Lane  3 , Rebecca Biviano  3 , Iris Bartula  3   4 , Frank Brennan  5 , Ingrid Kivikoski  6 , Jake Thompson  3 , Haryana M Dhillon  7   8 , Alexander Menzies  3   4   9   10 , Georgina V Long  3   4   9   10
Affiliations

Feasibility, acceptability, and utility of a nurse-led survivorship program for people with metastatic melanoma (MELCARE)

Julia Lai-Kwon et al. Support Care Cancer. 2022 Nov.

Abstract

Purpose: Immune checkpoint inhibitors (ICIs) and targeted therapy (TT) have improved the survival of people with metastatic melanoma. We assessed the feasibility, acceptability, and utility of a novel model of nurse-led, telehealth-delivered survivorship care (MELCARE) for this survivor group.

Methods: People ≥ 18 years diagnosed with unresectable stage III or stage IV melanoma who were ≥ 6 months post initiation of ICI/TT with a radiological response suggestive of a long-term response to ICI/TT were recruited from a specialist melanoma centre in Australia. All participants received MELCARE, a nurse-led survivorship program involving two telehealth consultations 3 months apart, needs assessment using the Distress Thermometer (DT) and Problem List, and creation of a survivorship care plan. Feasibility, acceptability, and utility were assessed using rates of consent and study completion, time taken to complete each component of MELCARE, the Acceptability of Intervention Measure (AIM), and a customised utility survey.

Results: 31/54 (57%) people consented. Participants were male (21, 68%), with a median age of 67 (range: 46-82). Eleven (35%) were receiving/had received ipilimumab and nivolumab and 27 (87%) had ceased treatment. Feasibility was demonstrated with 97% completing MELCARE. Utility was demonstrated on a customised survey and supported by a reduction in the mean DT score (initial: 5.6, SD: 2.9; follow-up: 1.5, SD: 1.2). Acceptability was demonstrated on 3/4 AIM items.

Conclusion: MELCARE was feasible and acceptable with high levels of utility. However, the consent rate was 57% indicating some people do not require support. Future studies should consider MELCARE's optimal timing, resourcing, and cost-effectiveness.

Keywords: Melanoma; Nursing; Quality of life; Survivorship; Telehealth.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

AMM is a consultant advisor to BMS, MSD, Novartis, Roche, Pierre-Fabre, and QBiotics.

GVL is a consultant advisor to Agenus, Amgen, Array Biopharma, Boehringer Ingelheim International, Bristol Myers Squibb, Evaxion, Hexal, Highlight Therapeutics S.L., Merck Sharpe & Dohme, Novartis Pharma, OncoSec, Pierre Fabre, Provectus, Qbiotics, Regeneron.

All other authors have no declarations of interest.

Figures

Fig. 1
Fig. 1
MELCARE intervention
Fig. 2
Fig. 2
MELCARE recruitment
Fig. 3
Fig. 3
Key acceptability and utility results
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Balch CM, et al. Final version of 2009 AJCC melanoma staging and classification. J Clin Oncol. 2009;27(36):6199–6206. - PMC - PubMed
    1. Robert C, et al. Pembrolizumab versus ipilimumab in advanced melanoma (KEYNOTE-006): post-hoc 5-year results from an open-label, multicentre, randomised, controlled, phase 3 study. Lancet Oncol. 2019;20(9):1239–1251. - PubMed
    1. Robert C, et al. Five-year outcomes with dabrafenib plus trametinib in metastatic melanoma. N Engl J Med. 2019;381(7):626–636. - PubMed
    1. Hodi FS, et al. Long-term survival in advanced melanoma for patients treated with nivolumab plus ipilimumab in CheckMate. J Clin Oncol. 2022;40(16_suppl):9522–9522.
    1. Lai-Kwon J, et al. The survivorship experience for patients with metastatic melanoma on immune checkpoint and BRAF-MEK inhibitors. J Cancer Surviv. 2019;13(4):503–511. - PubMed