Metastatic melanoma patient outcomes since introduction of immune checkpoint inhibitors in England between 2014 and 2018
| Autor: | Pippa Corrie, Hanhua Liu, Sarah Lawton, Rebecca Smittenaar, Bukky Juwa, David Chao, Ruth E Board |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male Cancer Research medicine.medical_specialty Adolescent Concordance Ipilimumab Kaplan-Meier Estimate Pembrolizumab Antibodies Monoclonal Humanized law.invention Young Adult 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Internal medicine Outcome Assessment Health Care medicine Humans Neoplasm Metastasis real world outcomes Immune Checkpoint Inhibitors Melanoma Aged Randomized Controlled Trials as Topic Aged 80 and over Performance status business.industry Mortality rate Middle Aged medicine.disease Nivolumab England Oncology 030220 oncology & carcinogenesis Female business checkpoint inhibitors Cancer Epidemiology metastatic melanoma medicine.drug |
| Zdroj: | International Journal of Cancer |
| ISSN: | 1097-0215 0020-7136 |
| Popis: | Immune checkpoint inhibitors (CPIs) have radically changed outcomes for patients diagnosed with metastatic melanoma globally in the last 10 years, based on evidence of overall survival (OS) benefits generated from international randomised controlled trials (RCTs). Since RCTs do not always reflect real‐world prescribing, we interrogated established national databases to track prescribing of CPIs approved for first line treatment of metastatic melanoma patients in England since 2014 and determined patient outcomes associated with OS, as well as treatment‐related toxicity. Between April 2014 and March 2018, 5465 melanoma patients were diagnosed and treated with systemic anticancer therapy (SACT), 2322 of which received first‐line CPIs. There was good 3‐year OS concordance with RCT outcomes for ipilimumab (32%), ipinivo (56%) and nivolumab (51%), but OS was lower than expected for pembrolizumab (40%). Comparing patients prescribed ipinivo with those prescribed pembrolizumab, ipinivo‐treated patients were younger (88% vs 49% patients What's new? Immune checkpoint inhibitors (CPIs) greatly impact overall survival in metastatic melanoma. In England, CPIs have been used as first‐line therapy for this malignancy since 2014. This retrospective study assessed survival and toxicity among English metastatic melanoma patients prescribed CPIs between 2014 and 2018. For the CPIs ipilimumab, nivolumab, and ipinivo, survival outcomes were remarkably similar to registration trials. Poorer outcomes were associated with pembrolizumab, possibly because patients who received this drug were older and relatively less fit. Ipinivo generated the highest rates of emergency hospital visits and admissions, although 30‐day mortality was unchanged, potentially reflecting effective management of complications. |
| Databáze: | OpenAIRE |
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