1394P - Changing treatment patterns in advanced & metastatic melanoma towards targeted therapies in EU5 countries from 2011 to 2015

Date 09 October 2016
Event ESMO 2016 Congress
Session Poster display
Topics Bioethics, Legal, and Economic Issues
Presenter Mathias Bernhardt
Citation Annals of Oncology (2016) 27 (6): 474-482. 10.1093/annonc/mdw387
Authors M. Bernhardt, N. Schmidt, K. Acker
  • Ims Global Oncology, IMS Health GmbH & Co. OHG, 60598 - Frankfurt/DE

Abstract

Background

Real world data on treatment (TX) patterns in advanced and metastatic melanoma is of great value to demonstrate the use of novel therapy options. We provide an overview about changes in the melanoma TX patterns in regard to novel targeting drugs that recently entered the market.

Methods

This study is based on IMS Oncology Analyzer™, a quarterly physician panel survey including anonymous retrospective patient (PT) data about disease and TX history, across all cancer types. Melanoma PTs treated within 2011, 2013 and 2015 in EU5 countries (France, Germany, Italy, Spain and UK) were analyzed.

Results

The percentage of chemotherapy (CT) receiving PTs decreased from to 68.4% in 2011, 43.3% in 2013 to 9.0% in 2015. In contrast, targeted therapies against members of the MAPK pathway increased from 5.3% in 2011, to 37.9% in 2013 and to ∼45.0% in 2015. In parallel, diagnostic test rates for BRAF increased to 94% in 2015. The number of PTs receiving immuno-oncology therapies as CTLA-4 inhibitors increased from ∼10% in 2011 and 2013 to ∼32% in 2015. In Addition, inhibitors of PD-1/PD-L1 entered the market in 2015 and gained market shares of 9.0%.

TX landscape of stage III/IV melanoma PTs *PTs included in a clinical trial or don't receiving a systemic therapy were not considered

TX regimens 2011 2013 2015
Base (number of sample PTs) All PTs* (244) All PTs* (346) All PTs* (587)
MEK&BRAF 5.3% 37.9% 44.8%
CTLA-4 10.7% 10.1% 31.9%
PD1/PD-L1 - - 9.0%
CT 68.4% 43.3% 9.0%
Others 15.6% 8.7% 5.3%
Share of BRAF tested PTs - 87.6% 94.2%

Conclusions

This study indicates a switch towards targeted therapies accounting for more than 80% of the melanoma treatments in 2015. Two particular classes of therapies, small molecules targeting the MAPK signaling pathway and immune-oncology agents replace conventional CTs. Besides MEK&BRAF inhibitors that already showed significant market shares in 2013, particularly antibodies against CTLA-4 or the PD-1/PD-L1 pathway are more commonly used in the TX of melanoma PTs. However, a population of 6% is still not tested for BRAF mutations. Therefore, further research is necessary to understand a missing uptake of novel TX options in the clinical practice.

Clinical trial identification

Legal entity responsible for the study

IMS Health GmbH & Co. Ohg

Funding

IMS Health GmbH & Co. Ohg

Disclosure

All authors have declared no conflicts of interest.