Despite the efficacy of innovative treatments for metastatic melanoma their high costs has led to disparities in cancer care among different European countries. We analyzed the availability of these innovative therapies in Europe, and estimated the number of patients without access to first-line recommended treatment per current (ESMO, EORTC/EADO) guidelines.
Web-based online survey was conducted in 34 oncology centers from 29 European countries with questions about the treatment schedules from 1st May 2015-1st May 2016: number of metastatic melanoma patients, percentage of patients treated with any of the new agents, data on registration and reimbursement of innovative medicines and availability of clinical studies for stage IV disease. Descriptive statistics were used to analyze the data.
In Western European countries at least 70% of patients were treated with innovative medicines, while in 41% of centers from Eastern and SE Europe less then 10% of patients had an access. Recommended first-line therapy for BRAF mutated metastatic melanoma, BRAFi + MEKi combination was registered in 75% and fully reimbursed in 58% countries of Western Europe, while in Eastern and SE Europe it was registered in 42% and reimbursed in 3/17 (18%) countries. First-line immunotherapy with any of the anti-PD1 antibodies was registered in Western Europe in every country while in Eastern and SE Europe it was registered in 10/17 (59%), but reimbursed in 4/17 (23.5%) countries. Based on estimated total number of metastatic melanoma patients and percentage of patients treated with innovative therapies, it can be estimated that at least 5000 of patients in Eastern and South-Eastern Europe do not have access to innovative treatments for metastatic melanoma.
Great discrepancy exists in metastatic melanoma treatment across Europe. It is crucial to increase the awareness of national and European policy makers, oncological societies, melanoma patients associations and pharma industry. *Additional contributors: Bylaite-Bucinskiene M, Zalaudek I, Maric-Brozic J, Vieira R, Babovic N, Kukushkina M, Banjin M, Putnik K, Weinlich G, Todorovic V, Kirov K, Risteski M, Ocvirk J, Ymeri A, Zhukavets A.
Clinical trial identification
Legal entity responsible for the study
European Association of Dermatooncology
European Association of Dermatooncology, but no funding was needed for the study
All authors have declared no conflicts of interest.