lnsights into Adjuvant Systemic Treatment Selection for Patients with Stage III Melanoma: Data from the Dutch Cancer Registry.

IF 4.4 3区医学 Q2 ONCOLOGY

Targeted Oncology Pub Date : 2024-09-01 Epub Date: 2024-08-24 DOI:10.1007/s11523-024-01090-9

Loeki Aldenhoven, Merel A Spiekerman van Weezelenburg, Franchette W P J van den Berkmortel, Nick Servaas, Alfred Janssen, Yvonne L J Vissers, Elisabeth R M van Haaren, Geerard L Beets, James van Bastelaar

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Abstract

Background: Patient demographics and shared decision making might influence the choice of adjuvant therapy for stage III melanoma.

Objective: To identify factors for treatment selection of patients diagnosed with stage III melanoma to better understand current treatment decisions and improve further treatment counseling.

Patients and methods: Data from 2007 patients diagnosed with stage III melanoma, between December 2018 and 2021, sourced from the Dutch Cancer Registry, were analyzed.

Results: Among the cohort, 48.7% received no therapy, 45.8% received checkpoint inhibition, and 5.5% received targeted therapy (TT). Patients foregoing therapy were significantly older [67.0 years (range 53.0-77.0) vs. 62.0 year (range 52.0-72.0)], had poorer performance scores (PS), and higher Charlson Comorbidity Index scores compared to those receiving therapy (p < 0.001). Patients undergoing therapy had significantly higher median Breslow thickness (3.3 mm vs. 2.2 mm) and higher prevalence of ulceration (49.9% vs. 38.1%). Those with connective tissue disease and/or congestive heart disease were more likely to receive TT [odds ration (OR) 8.1; 95% confidence interval (CI) 1.7-37.6 and OR 9.3; 95% CI 1.2-72.2, respectively]. Median treatment time among strata for disease recurrence was 4.26 months (3.69-4.82) for immunotherapy and 3.1 months (0.85-5.36) for TT (p = 0.298). Patients who developed recurrent disease were equal across treatment types (p = 0.656). The number of patients with grade 3 complications was different for each treatment type [immunotherapy: 17.8% vs. TT: 37.3% (p < 0.001)].

Conclusions: Age, PS, and Breslow thickness seem to influence adjuvant treatment decisions. Clinicians' preference for immunotherapy might play a role in counseling BRAF-positive patients for adjuvant therapy, this however, cannot be confirmed in this dataset. Overall, only a small proportion of patients completed adjuvant treatment.

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对 III 期黑色素瘤患者辅助系统治疗选择的洞察：来自荷兰癌症登记处的数据。

背景：患者的人口统计学特征和共同决策可能会影响 III 期黑色素瘤辅助治疗的选择：患者人口统计学和共同决策可能会影响III期黑色素瘤辅助治疗的选择：确定确诊为III期黑色素瘤患者的治疗选择因素，以更好地了解当前的治疗决策并改进进一步的治疗咨询：分析了2018年12月至2021年间2007名确诊为III期黑色素瘤患者的数据，数据来源于荷兰癌症登记处：在队列中，48.7%的患者未接受治疗，45.8%的患者接受了检查点抑制治疗，5.5%的患者接受了靶向治疗（TT）。与接受治疗的患者相比，放弃治疗的患者年龄明显偏大[67.0岁（范围53.0-77.0） vs. 62.0岁（范围52.0-72.0）]，表现评分（PS）较差，Charlson合并症指数评分较高（P 结论：接受治疗的患者年龄、PS和Breslow评分均高于放弃治疗的患者：年龄、体能评分和布雷斯罗厚度似乎会影响辅助治疗的决定。临床医生对免疫疗法的偏好可能会在指导 BRAF 阳性患者接受辅助治疗时发挥作用，但这一点无法在本数据集中得到证实。总体而言，只有一小部分患者完成了辅助治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Targeted Oncology 医学-肿瘤学

CiteScore

8.40

自引率

3.70%

发文量

审稿时长

>12 weeks

期刊介绍： Targeted Oncology addresses physicians and scientists committed to oncology and cancer research by providing a programme of articles on molecularly targeted pharmacotherapy in oncology. The journal includes: Original Research Articles on all aspects of molecularly targeted agents for the treatment of cancer, including immune checkpoint inhibitors and related approaches. Comprehensive narrative Review Articles and shorter Leading Articles discussing relevant clinically established as well as emerging agents and pathways. Current Opinion articles that place interesting areas in perspective. Therapy in Practice articles that provide a guide to the optimum management of a condition and highlight practical, clinically relevant considerations and recommendations. Systematic Reviews that use explicit, systematic methods as outlined by the PRISMA statement. Adis Drug Reviews of the properties and place in therapy of both newer and established targeted drugs in oncology.