Targeted and Checkpoint Inhibitor Therapy of Metastatic Malignant Melanoma in Germany, 2000–2016
1
Center for Evidence-based Healthcare, Faculty of Medicine and University Hospital Carl Gustav Carus, TU Dresden, 01307 Dresden, Germany
2
Faculty of Medicine and University Hospital Carl Gustav Carus, Department of Dermatology, Skin Cancer Center at the University Cancer Centre and National Center for Tumor Diseases, TU Dresden, 01307 Dresden, Germany
*
Author to whom correspondence should be addressed.
Cancers 2020, 12(9), 2354; https://doi.org/10.3390/cancers12092354
Received: 16 July 2020
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Revised: 14 August 2020
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Accepted: 18 August 2020
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Published: 20 August 2020
(This article belongs to the Special Issue Targeted Therapies for Melanoma)
Targeted therapies (TT) and immune checkpoint inhibitors (ICI) have become increasingly important in the treatment of metastatic malignant melanoma in recent years. We examined implementation and effectiveness of these new therapies over time in Germany with a focus on regional differences. We analyzed data from 12 clinical cancer registries in 8 federal states in Germany over the period 2000–2016. A total of 3871 patients with malignant melanoma in Union internationale contre le cancer (UICC) stage IV at primary diagnosis (synchronous metastases) or with metachronous metastases were included. We investigated differences in survival of patients treated with new and conventional therapies by log-rank tests for Kaplan–Meier curves. Cox regression models were estimated to adjust therapy effects for demographic, regional, and prognostic factors. New systemic therapies were increasingly applied throughout Germany. TT were most frequently documented in Eastern Germany (East: 11.2%; West: 6.3%), whereas ICI therapies were more frequently used in Western Germany (East: 1.7%; West: 3.9%). TT had a relevant influence on patient survival (hazard ratio (HR) = 0.831; 95%-CI = (0.729; 0.948)). Survival was worse in Eastern Germany (HR = 1.470; 95%-CI = (1.347; 1.604)) relative to Western Germany. Treatment and survival prospects of patients with melanoma differed considerably between Western and Eastern Germany. The differences in regional medication behavior and survival require further exploration.
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Keywords:
melanoma; metastatic malignant melanoma; targeted therapy; immune checkpoint inhibitor; relative survival; cancer registry data
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MDPI and ACS Style
Hellmund, P.; Schmitt, J.; Roessler, M.; Meier, F.; Schoffer, O. Targeted and Checkpoint Inhibitor Therapy of Metastatic Malignant Melanoma in Germany, 2000–2016. Cancers 2020, 12, 2354. https://doi.org/10.3390/cancers12092354
AMA Style
Hellmund P, Schmitt J, Roessler M, Meier F, Schoffer O. Targeted and Checkpoint Inhibitor Therapy of Metastatic Malignant Melanoma in Germany, 2000–2016. Cancers. 2020; 12(9):2354. https://doi.org/10.3390/cancers12092354
Chicago/Turabian StyleHellmund, Peter, Jochen Schmitt, Martin Roessler, Friedegund Meier, and Olaf Schoffer. 2020. "Targeted and Checkpoint Inhibitor Therapy of Metastatic Malignant Melanoma in Germany, 2000–2016" Cancers 12, no. 9: 2354. https://doi.org/10.3390/cancers12092354
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