Incidence/prevalence of melanoma in Asia are both 3% of that in Europe. However, westernization of the Asian population (increase in UV exposure and sun-seeking), is impacting these traditionally low figures. Local drug regulatory agencies have anticipated a shift in treatment from standard to novel molecular targeted and immunotherapeutic products. This study examines treatment differences in melanoma patients in EU5 and Japan, considering dissimilarities between populations.
A large sample of 4,209 drug treated melanoma cases were collected January 2017-March 2018 through a cross sectional survey in EU5 (France, Germany, Spain, Italy, UK), and Japan. Testing for genetic mutations and drug use were analysed for 3,997 advanced/metastatic (adv/met) patients.
When specified, Acral Lentiginous Melanoma (ALM) and Nodular Melanoma were the most common histology in Japan (25%) during the investigated period, while being only 4% in EU5, where nodular melanoma (23%) and superficial spreading melanoma (21%) were the most frequent. Anti PD1/CTLA4 lead the adv/met melanoma setting in EU5 (58%), followed by BRAF (35%) and MEK inhibitors (19%). In Japan, although anti PD1/CTLA4 play an important role in adv/met melanoma (57%), BRAF and MEK inhibitors are uncommon (up to 2% use) and other standard drugs (Interferons, Anthracyclines, Platinum-based, other chemotherapy) which are uncommon in EU5 (4% use at most), are used in up to 21% of Japanese patients. BRAF mutations were tested in 96% in EU5 vs. 52% in Japan for adv/met patients, with 48% and 26% positive cases respectively. PD1 testing was higher in Japan (40%), also presenting a larger PD1 positive population (17%) than the European counterpart.
We have demonstrated penetration of novel immuno-oncology drugs both in Europe and Japan. Existing differences in melanoma treatment between both regions provide insights on Asian populations, which are not as well documented. Although these might be influenced by ethnic and genetic factors, maturity of the region should be considered and further analyses would provide an interesting observation on the trend of both regions.
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Has not received any funding.
All authors have declared no conflicts of interest.