Factors Influencing the Adjuvant Therapy Decision: Results of a Real-World Multicenter Data Analysis of 904 Melanoma Patients
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Factors Influencing the Adjuvant Therapy Decision: Results of a Real-World Multicenter Data Analysis of 904 Melanoma Patients. / Lodde, Georg; Forschner, Andrea; Hassel, Jessica; Wulfken, Lena M; Meier, Friedegund; Mohr, Peter; Kähler, Katharina; Schilling, Bastian; Loquai, Carmen; Berking, Carola; Hüning, Svea; Schatton, Kerstin; Gebhardt, Christoffer; Eckardt, Julia; Gutzmer, Ralf; Reinhardt, Lydia; Glutsch, Valerie; Nikfarjam, Ulrike; Erdmann, Michael; Stang, Andreas; Kowall, Bernd; Roesch, Alexander; Ugurel, Selma; Zimmer, Lisa; Schadendorf, Dirk; Livingstone, Elisabeth.
In: CANCERS, Vol. 13, No. 10, 2319, 12.05.2021.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Factors Influencing the Adjuvant Therapy Decision: Results of a Real-World Multicenter Data Analysis of 904 Melanoma Patients
AU - Lodde, Georg
AU - Forschner, Andrea
AU - Hassel, Jessica
AU - Wulfken, Lena M
AU - Meier, Friedegund
AU - Mohr, Peter
AU - Kähler, Katharina
AU - Schilling, Bastian
AU - Loquai, Carmen
AU - Berking, Carola
AU - Hüning, Svea
AU - Schatton, Kerstin
AU - Gebhardt, Christoffer
AU - Eckardt, Julia
AU - Gutzmer, Ralf
AU - Reinhardt, Lydia
AU - Glutsch, Valerie
AU - Nikfarjam, Ulrike
AU - Erdmann, Michael
AU - Stang, Andreas
AU - Kowall, Bernd
AU - Roesch, Alexander
AU - Ugurel, Selma
AU - Zimmer, Lisa
AU - Schadendorf, Dirk
AU - Livingstone, Elisabeth
PY - 2021/5/12
Y1 - 2021/5/12
N2 - Adjuvant treatment of melanoma patients with immune-checkpoint inhibition (ICI) and targeted therapy (TT) significantly improved recurrence-free survival. This study investigates the real-world situation of 904 patients from 13 German skin cancer centers with an indication for adjuvant treatment since the approval of adjuvant ICI and TT. From adjusted log-binomial regression models, we estimated relative risks for associations between various influence factors and treatment decisions (adjuvant therapy yes/no, TT vs. ICI in BRAF mutant patients). Of these patients, 76.9% (95% CI 74-80) opted for a systemic adjuvant treatment. The probability of starting an adjuvant treatment was 26% lower in patients >65 years (RR 0.74, 95% CI 68-80). The most common reasons against adjuvant treatment given by patients were age (29.4%, 95% CI 24-38), and fear of adverse events (21.1%, 95% CI 16-28) and impaired quality of life (11.9%, 95% CI 7-16). Of all BRAF-mutated patients who opted for adjuvant treatment, 52.9% (95% CI 47-59) decided for ICI. Treatment decision for TT or ICI was barely associated with age, gender and tumor stage, but with comorbidities and affiliated center. Shortly after their approval, adjuvant treatments have been well accepted by physicians and patients. Age plays a decisive role in the decision for adjuvant treatment, while pre-existing autoimmune disease and regional differences influence the choice between TT or ICI.
AB - Adjuvant treatment of melanoma patients with immune-checkpoint inhibition (ICI) and targeted therapy (TT) significantly improved recurrence-free survival. This study investigates the real-world situation of 904 patients from 13 German skin cancer centers with an indication for adjuvant treatment since the approval of adjuvant ICI and TT. From adjusted log-binomial regression models, we estimated relative risks for associations between various influence factors and treatment decisions (adjuvant therapy yes/no, TT vs. ICI in BRAF mutant patients). Of these patients, 76.9% (95% CI 74-80) opted for a systemic adjuvant treatment. The probability of starting an adjuvant treatment was 26% lower in patients >65 years (RR 0.74, 95% CI 68-80). The most common reasons against adjuvant treatment given by patients were age (29.4%, 95% CI 24-38), and fear of adverse events (21.1%, 95% CI 16-28) and impaired quality of life (11.9%, 95% CI 7-16). Of all BRAF-mutated patients who opted for adjuvant treatment, 52.9% (95% CI 47-59) decided for ICI. Treatment decision for TT or ICI was barely associated with age, gender and tumor stage, but with comorbidities and affiliated center. Shortly after their approval, adjuvant treatments have been well accepted by physicians and patients. Age plays a decisive role in the decision for adjuvant treatment, while pre-existing autoimmune disease and regional differences influence the choice between TT or ICI.
U2 - 10.3390/cancers13102319
DO - 10.3390/cancers13102319
M3 - SCORING: Journal article
C2 - 34065995
VL - 13
JO - CANCERS
JF - CANCERS
SN - 2072-6694
IS - 10
M1 - 2319
ER -