Abstract 3139
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 the application of diagnostic marker testing and its implication on 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 the year 2013 and 2015 in EU5 countries (France, Germany, Italy, Spain and UK) were analyzed.
Results
In 2013, 45.7% of adv. & met. melanoma PTs received chemotherapy (CT) in their 1st line, ∼45% received a targeted therapy either against members of the MAPK or the CTLA-4 pathway while 9% were treated with others drugs. In 2015, the percentage of CT PTs decreased to ∼10% while ∼85% of PTs received a targeted therapy including anti-PD1/PD-L1 TXs. Distribution of the PTs according their BRAF status shows that 2% of BRAF mutant (MUT) but ∼20% of wild type (WT) PTs are treated with CTs in their first line in 2015.
| 1st line TX regimens** | 2013 | 2015 | ||||
|---|---|---|---|---|---|---|
| Base (sample PTs) | All PTs (304) | BRAF* WT (44.9%) | BRAF* MUT (55.1%.) | All PTs (481) | BRAF* WT (39.6%) | BRAF* MUT (60.4%) |
| MEK&BRAF | 40.8% | 1.7% | 83.6% | 48.4% | 1.1% | 84.5% |
| CTLA-4 | 4.3% | 4.2% | 4.1% | 32.2% | 66.9% | 12.2% |
| PD1/PD-L1 | - | - | - | 4.2% | 8.4% | 1.5% |
| CT | 45.7% | 89.9% | 9.6% | 9.6% | 19.1% | 1.8% |
| Others | 9.2% | 4.2% | 2.7% | 5.6% | 4.5% | - |
** PTs included in a clinical trial or don't receiving a systemic therapy were not considered *PTs with an unknown BRAF status or PTs awaiting test results were excluded Table 1: Stage III/IV melanoma 1st line TX landscape
Conclusions
This study indicates a switch towards targeted therapies accounting for more than 80% of 1st line melanoma therapies in 2015. Hereby, the information on the BRAF status is crucial and determines the TX decision in regard of the drug type. However, nearly 20% of BRAF WT PTs receive CTs in their 1st line irrespective of novel available therapy options. Further research is necessary to understand the missing uptake of novel TX options and the related clinical practice.
Clinical trial identification
Legal entity responsible for the study
IMS Health GmbH & Co. Ohg
Funding
IMS Health GmbH & Co. Ohg
Disclosure
M. Bernhardt, N. Schmidt, K. Acker: Employee of IMS Health