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. 2025 Feb 5:216:115124.
doi: 10.1016/j.ejca.2024.115124. Epub 2024 Nov 16.

An update on access to novel treatment for metastatic melanoma in Europe - A 2024 survey of the European melanoma registry and the European association of dermato-oncology

L Kandolf  1 , P A Ascierto  2 , L Bastholt  3 , I Gavrilova  4 , J Haanen  5 , A Hauschild  6 , D Herceg  7 , C Hoeller  8 , A Jalovcic Suljevic  9 , J I Kessels  10 , I Krajsova  11 , M Kukushkina  12 , A Lallas  13 , P Lorigan  14 , J Mangana  15 , I Marquez-Rodas  16 , L Mazilu  17 , P Mohr  18 , M Bylaite-Bucinskiene  19 , J Ocvirk  20 , J Olah  21 , K Putnik  22 , P Rutkowski  23 , P Saiag  24 , I Samolyenko  25 , J K Schwarze  26 , I Stojkovski  27 , N Cicmil Sarić  28 , R Vieira  29 , M Weichenthal  30 , C Garbe  31
Affiliations

An update on access to novel treatment for metastatic melanoma in Europe - A 2024 survey of the European melanoma registry and the European association of dermato-oncology

L Kandolf et al. Eur J Cancer. .

Abstract

Advances in cancer treatments have significantly improved their effectiveness, yet access to first-line therapies remains limited. A 2017 survey revealed that over 25 % of metastatic melanoma patients in Europe lacked access to recommended therapies. To address this, the European Association of Dermato-Oncology and the European Melanoma Registry conducted a follow-up study on the registration and reimbursement of first-line treatments.A web-based survey using LimeSurvey was distributed to melanoma experts across 27 European countries from February to April 2022 and updated from February to April 2024. The questionnaire covered the percentage of patients receiving recommended treatments, as well as treatment authorization and reimbursement dates for systemic and adjuvant therapies.There has been significant improvement in the registration and reimbursement of BRAFi/MEKi, anti-PD1, and anti-PD1/anti-CTLA4 therapies, increasing from 48 %, 63 %, and 37 % in 2017 to 96 %, 96 %, and 78 % in 2024, respectively. Despite these gains, restrictions persist. Anti-PD1/anti-CTLA4 combination immunotherapy is still not available without restrictions in 48 % of the surveyed countries. The nivolumab/relatlimab combination is licensed only for PDL-1-negative melanoma and reimbursed in seven countries of Europe. Tebentafusp is reimbursed in 15 countries and talimogene laherpervec in 5. In 2024, adjuvant treatments for stage III melanoma are reimbursed in 22 countries for dabrafenib/trametinib and 24 of 27 for anti-PD1 antibodies. Pembrolizumab and nivolumab are reimbursed in 15 and 8 countries, respectively, for stage IIB/IIC disease.While there have been improvements in the reimbursement of metastatic melanoma treatments in Europe, challenges and discrepancies remain. Further efforts at European and global levels are needed to harmonize and enhance access to cancer medicines.

Keywords: Access to medicines; Cancer care; Disparities; Immunotherapy; Melanoma; Targeted therapy.

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Conflict of interest statement

Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:LK received consulting fees from MSD, Merck, AbbVie, and Janssen; honoraria for lectures and presentations from BMS, MSD, Novartis, Merck, Roche, AbbVie, and Janssen, support for attending meetings and travel from BMS, MSD, Novartis, and Janssen, outside of submitted work. NCS received consulting fees from MSD, Roche, and Novartis. JKS received non-financial support from MSD and Amgen, personal fees from Novartis, and payments to her institution from AstraZeneca, Roche, MSD, BMS, Servier, and Lilly for advisory boards, consultancy, lectures, and travel. PL received consulting fees from Amgen, BMS, MSD, Nektar, Novartis, and Pierre Fabre, honoraria for lectures and presentations from Amgen, BMS, Merck, MSD, Nektar, NeraCare GmbH, Novartis, Oncology Education, Pierre Fabre, and Roche, and support for attending meetings and travel from BMS and MSD. IS received honoraria for lectures and presentations from Roche, Novartis, Swixx, Pierre Fabre, BIOCAD, and R-Farm, with no other financial or non-financial interests reported. PA has nothing to disclose. CH reports personal fees from MSD, Roche, Novartis, BMS, Pierre Fabre, outside the submitted work. HG includes honoraria from BMS, MSD Oncology, Pierre Fabre, and Sanofi/Regeneron, consulting or advisory roles with BMS, MSD Oncology, Pierre Fabre, and Sanofi/Regeneron, research funding from BMS, Roche, MSD Oncology, Amgen, Novartis, and Iovance Biotherapeutics (all to the institution), and travel, accommodations, and expenses covered by MSD, Pfizer, and Sanofi. IG reported roles with speakers' bureaux for Roche, Novartis, MSD, BMS, Sanofi, Merck, Pierre Fabre, and Medison, received honoraria from Roche, Novartis, MSD, BMS, Sanofi, Merck, Pierre Fabre, and Medison, and held consulting/advisory roles with MSD, BMS, Pierre Fabre, and Medison, along with travel/accommodations expenses from MSD, BMS, and Pierre Fabre. JH received honoraria from BMS, MSD, Novartis, Pierre Fabre, and Sunpharma, with consulting/advisory roles at AstraZeneca, BioNTech, BMS, Novartis, research funding from BMS, MSD, Novartis, Amgen, Roche, and Pfizer (to institution), and travel/accommodations support from Pierre Fabre. PA held consultant/advisory roles with Bristol Myers Squibb, Roche-Genentech, Merck Sharp & Dohme, Novartis, Merck Serono, and other companies, received research funding from Bristol Myers Squibb, Roche-Genentech, Pfizer, and Sanofi (to institution), and received travel support from Pfizer, Bio-Al Health, Replimmune, MSD, and Pierre Fabre. LM declared no known competing financial interests or personal relationships. JM reported consulting/advisory roles with Merck/Pfizer, Merck Sharp & Dohme, Novartis, Roche, Pierre Fabre, and Bristol Myers Squibb, and received travel/congress support from Ultrasun, L′Oreal, Merck Sharp & Dohme, Bristol Myers Squibb, and Pierre Fabre. PR reported consulting fees from BMS, MSD, Novartis, Pierre Fabre, Philogen, Pfizer, Genesis, and Madison Pharma, received payment or honoraria from BMS, MSD, Novartis, Pfizer, Pierre Fabre, Sanofi, Merck, and AstraZeneca, was part of speakers’ bureau for Pfizer, Novartis, Pierre Fabre, MSD, and BMS, and received support for meetings/travel from Orphan Europe and Pierre Fabre, along with research funding from Novartis, Pfizer, Roche, and BMS (to institution). JO declared no known competing financial interests or personal relationships. MR held advisory roles at Amgen, AstraZeneca, BiolineRx, BMS, Celegene, GSK, Highlight Therapeutics, Immunocore, Merck Serono, MSD, Novartis, Pierre Fabre, Regeneron, Roche, Sanofi, and Sun Pharma, and received travel/accommodation support from Amgen, BMS, GSK, Highlight Therapeutics, MSD, Novartis, Pierre Fabre, Roche, and Sun Pharma. MK gave lectures for MSD, Novartis, and Roche, and received travel grants from MSD, Novartis, and Roche. JuO received speaker fees from MSD, Sanofi, Novartis, and BMS. IS declared no known competing financial interests or personal relationships. JK was a speaker for BMS and Janssen. LB declared no known competing financial interests or personal relationships. PM received honoraria for advisory or consultancy roles with Pierre Fabre, GSK, MSD, Merck Germany, Roche, BMS, Novartis, Sanofi, Immunocore, Sun Pharma, and Regeneron, research grant/funding from BMS, Novartis, and MSD, and travel/accommodations support from Pierre Fabre, MSD, Merck, Sun Pharma, and Regeneron. CG reported consulting fees and honoraria from MSD, Novartis, NeraCare, BMS, Philogen, and Sanofi. PS received honoraria from Novartis, BMS, Pierre Fabre, MSD, and Merck-Serrono, with travel support from ASCO, EADV, and ESMO. AH received grants from MSD/Merck, Philogen, Pierre Fabre, Regeneron, Roche, Sanofi-Genzyme, Novartis, and Eisai, honoraria from MSD/Merck, Pierre Fabre, Regeneron, Roche, Sanofi-Genzyme, Novartis, and Eisai, and served on advisory boards for MSD/Merck, Pierre Fabre, Regeneron, Roche, Sanofi-Genzyme, Novartis, Eisai, Immunocore, Replimune, and Seagen. AL declared no competing interests. AMF received honoraria from Novartis.

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