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

Autor: Aldenhoven L; Department of Surgery, Zuyderland Medical Center, P.O. Box 5500, 6130 MB, Sittard-Geleen, The Netherlands. l.aldenhoven@zuyderland.nl., van Weezelenburg MAS; Department of Surgery, Zuyderland Medical Center, P.O. Box 5500, 6130 MB, Sittard-Geleen, The Netherlands., van den Berkmortel FWPJ; Department of Medical Oncology, Zuyderland Medical Center, Sittard, The Netherlands., Servaas N; Department of Surgery, Zuyderland Medical Center, P.O. Box 5500, 6130 MB, Sittard-Geleen, The Netherlands., Janssen A; Department of Surgery, Zuyderland Medical Center, P.O. Box 5500, 6130 MB, Sittard-Geleen, The Netherlands., Vissers YLJ; Department of Surgery, Zuyderland Medical Center, P.O. Box 5500, 6130 MB, Sittard-Geleen, The Netherlands., van Haaren ERM; Department of Surgery, Zuyderland Medical Center, P.O. Box 5500, 6130 MB, Sittard-Geleen, The Netherlands., Beets GL; Department of Surgery, Netherlands Cancer Institute, Amsterdam, The Netherlands.; GROW-School for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands., van Bastelaar J; Department of Surgery, Zuyderland Medical Center, P.O. Box 5500, 6130 MB, Sittard-Geleen, The Netherlands.
Jazyk: angličtina
Zdroj: Targeted oncology [Target Oncol] 2024 Sep; Vol. 19 (5), pp. 735-745. Date of Electronic Publication: 2024 Aug 24.
DOI: 10.1007/s11523-024-01090-9
Abstrakt: 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.
(© 2024. The Author(s).)
Databáze: MEDLINE
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