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Outcomes of stage IV melanoma in the era of immunotherapy: a National Cancer Database (NCDB) analysis from 2014 to 2016.

Publication ,  Journal Article
Sussman, TA; Knackstedt, R; Wei, W; Funchain, P; Gastman, BR
Published in: Journal for immunotherapy of cancer
August 2022

To evaluate factors affecting the utilization of immunotherapy and to stratify results based on the approval of ipilimumab in 2011 and programmed death-1 inhibitors in 2014, an analysis of available data from the National Cancer Database (NCDB) was performed.The NCDB was analyzed to identify patients with stage IV melanoma from 2004 to 2016. Patients were categorized during the time periods 2004-2010, 2011-2014, and 2015-2016. Overall survival (OS) was analyzed by Kaplan-Meier, log-rank, and Cox proportional hazard models; IO status was analyzed using logistic regression.24,544 patients were analyzed. Overall, 5238 patients (21.3%) who received IO had improved median OS compared with those who did not (20.2 months vs 7.4 months; p<0.0001). Between 2004 and 2010, 9.7% received immunotherapy; from 2011 to 2014, 21.9% received immunotherapy; and from 2015 to 2016, 43.5% received immunotherapy. Three-year OS significantly improved in patients treated with IO across treatment years: 31% (95% CI 29% to 34%) from 2004 to 2010, 35% (95% CI 33% to 37%) from 2011 to 2014, and 46% (95% CI 44% to 48%) from 2015 to 2016 (p<0.0001). Survival was worse in patients who did not receive IO during these treatment years: 16% (15%-17%), 21% (20%-22%), and 27% (25%-28%), respectively. In the overall cohort, age <65 years, female gender, private insurance, no comorbidities, residence in metropolitan area, and treatment at academic centers were associated with better OS (p<0.0001 for all). In the multivariate analysis, receipt of IO from 2015 to 2016 was associated with age <65 years (OR 1.27, 95% CI 1.08 to 1.50), African American race (OR 5.88, 95% CI 1.60 to 28.58), lack of comorbidities (OR 1.43, 95% CI 1.23 to 1.66), and treatment at academic centers (OR 1.44, 95% CI 1.26 to 1.65) (p<0.05 for all).OS improved in patients with stage IV melanoma receiving IO, with the highest OS rate in 2015-2016. Our findings, which represent a real-world population, are slightly lower than recent trials, such as KEYNOTE-006 and CheckMate 067. Significant socioeconomic factors may impact receipt of IO and survival.

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Published In

Journal for immunotherapy of cancer

DOI

EISSN

2051-1426

ISSN

2051-1426

Publication Date

August 2022

Volume

10

Issue

8

Start / End Page

e004994

Related Subject Headings

  • Neoplasm Staging
  • Melanoma
  • Ipilimumab
  • Immunotherapy
  • Immunologic Factors
  • Humans
  • Female
  • Databases, Factual
  • Aged
  • 3211 Oncology and carcinogenesis
 

Citation

APA
Chicago
ICMJE
MLA
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Sussman, T. A., Knackstedt, R., Wei, W., Funchain, P., & Gastman, B. R. (2022). Outcomes of stage IV melanoma in the era of immunotherapy: a National Cancer Database (NCDB) analysis from 2014 to 2016. Journal for Immunotherapy of Cancer, 10(8), e004994. https://doi.org/10.1136/jitc-2022-004994
Sussman, Tamara A., Rebecca Knackstedt, Wei Wei, Pauline Funchain, and Brian R. Gastman. “Outcomes of stage IV melanoma in the era of immunotherapy: a National Cancer Database (NCDB) analysis from 2014 to 2016.Journal for Immunotherapy of Cancer 10, no. 8 (August 2022): e004994. https://doi.org/10.1136/jitc-2022-004994.
Sussman TA, Knackstedt R, Wei W, Funchain P, Gastman BR. Outcomes of stage IV melanoma in the era of immunotherapy: a National Cancer Database (NCDB) analysis from 2014 to 2016. Journal for immunotherapy of cancer. 2022 Aug;10(8):e004994.
Sussman, Tamara A., et al. “Outcomes of stage IV melanoma in the era of immunotherapy: a National Cancer Database (NCDB) analysis from 2014 to 2016.Journal for Immunotherapy of Cancer, vol. 10, no. 8, Aug. 2022, p. e004994. Epmc, doi:10.1136/jitc-2022-004994.
Sussman TA, Knackstedt R, Wei W, Funchain P, Gastman BR. Outcomes of stage IV melanoma in the era of immunotherapy: a National Cancer Database (NCDB) analysis from 2014 to 2016. Journal for immunotherapy of cancer. 2022 Aug;10(8):e004994.
Journal cover image

Published In

Journal for immunotherapy of cancer

DOI

EISSN

2051-1426

ISSN

2051-1426

Publication Date

August 2022

Volume

10

Issue

8

Start / End Page

e004994

Related Subject Headings

  • Neoplasm Staging
  • Melanoma
  • Ipilimumab
  • Immunotherapy
  • Immunologic Factors
  • Humans
  • Female
  • Databases, Factual
  • Aged
  • 3211 Oncology and carcinogenesis