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Article

Real World Outcomes in Patients with Advanced Melanoma Treated in Alberta, Canada: A Time-Era Based Analysis

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Tom Baker Cancer Centre, Division of Medical Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
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Gastrointestinal Cancer and Melanoma Clinical Research Program, Cumming School of Medicine at the University of Calgary and Alberta Health Services, Calgary, AB T2N 1N4, Canada
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Cambridge Memorial Hospital, Cambridge, ON N1R 3G2, Canada
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Centre for Health Informatics, University of Calgary, Calgary, AB T2N 1N4, Canada
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Oncology Outcomes Research Initiative, University of Calgary, Calgary, AB T2N 1N4, Canada
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Cancer Control Alberta, Alberta Health Services, Calgary, AB T2N 1N4, Canada
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Clinical Research Unit, Tom Baker Cancer Centre, Calgary, AB T2N 1N4, Canada
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Author to whom correspondence should be addressed.
Curr. Oncol. 2021, 28(5), 3978-3986; https://doi.org/10.3390/curroncol28050338
Received: 18 September 2021 / Accepted: 2 October 2021 / Published: 5 October 2021
(This article belongs to the Section Medical Oncology)
Immune checkpoint and MAP kinase pathway inhibitors can significantly improve long-term survival for patients with melanoma. There is limited real-world data of these regimens’ effectiveness. We retrospectively analyzed 402 patients with unresectable and metastatic melanoma between August 2013 and July 2020 treated with immune checkpoint inhibitors and MAP kinase pathway targeted therapy in Alberta, Canada. Overall survival (OS) was compared using Kaplan–Meier and Cox regression analyses. Subgroup survival outcomes were analyzed by first-line treatment regime and BRAF mutation status. Three treatment eras were defined based on drug access: prior to August 2013, August 2013 to November 2016, and November 2016 to July 2020. Across each era, there were improvements in median OS: 11.7 months, 15.9 months, and 33.6 months, respectively. Patients with BRAF mutant melanoma had improved median OS when they were treated with immunotherapy in the first line as opposed to targeted therapy (median OS not reached for immunotherapy versus 17.4 months with targeted treatment). Patients with BRAF wild-type melanomas had improved survival with ipilimumab and nivolumab versus those treated with a single-agent PD-1 inhibitor (median OS not reached and 21.2 months). Our real-world analysis confirms significant survival improvements with each subsequent introduction of novel therapies for advanced melanoma.
Keywords: melanoma; overall survival; ipilimumab; nivolumab; targeted therapy; BRAF mutation; real-world study melanoma; overall survival; ipilimumab; nivolumab; targeted therapy; BRAF mutation; real-world study
MDPI and ACS Style

Rigo, R.; Doherty, J.; Koczka, K.; Kong, S.; Ding, P.Q.; Cheng, T.; Cheung, W.Y.; Monzon, J.G. Real World Outcomes in Patients with Advanced Melanoma Treated in Alberta, Canada: A Time-Era Based Analysis. Curr. Oncol. 2021, 28, 3978-3986. https://doi.org/10.3390/curroncol28050338

AMA Style

Rigo R, Doherty J, Koczka K, Kong S, Ding PQ, Cheng T, Cheung WY, Monzon JG. Real World Outcomes in Patients with Advanced Melanoma Treated in Alberta, Canada: A Time-Era Based Analysis. Current Oncology. 2021; 28(5):3978-3986. https://doi.org/10.3390/curroncol28050338

Chicago/Turabian Style

Rigo, Rodrigo, Jordan Doherty, Kim Koczka, Shiying Kong, Philip Q. Ding, Tina Cheng, Winson Y. Cheung, and Jose G. Monzon 2021. "Real World Outcomes in Patients with Advanced Melanoma Treated in Alberta, Canada: A Time-Era Based Analysis" Current Oncology 28, no. 5: 3978-3986. https://doi.org/10.3390/curroncol28050338

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