دورية أكاديمية
أعرض في EDS

Assessing the use of anti-PD1 monotherapy as adjuvant therapy and determinants of treatment choice in stage III cutaneous melanoma in the US.

التفاصيل البيبلوغرافية
العنوان: Assessing the use of anti-PD1 monotherapy as adjuvant therapy and determinants of treatment choice in stage III cutaneous melanoma in the US.
المؤلفون: Whitman ED; Atlantic Health System Cancer Care, Morristown, NJ, USA.; Atlantic Melanoma Center, Morristown, NJ, USA., Totev TI; Analysis Group, Inc., Boston, MA, USA. todor.totev@analysisgroup.com., Jiang S; Merck and Co., Inc., Rahway, NJ, USA., da Costa WL Jr; Analysis Group, Inc., Boston, MA, USA., Grebennik D; Merck and Co., Inc., Rahway, NJ, USA., Wang H; Analysis Group, Inc., Boston, MA, USA., Boca AE; Analysis Group, Inc., Boston, MA, USA., Ayyagari R; Analysis Group, Inc., Boston, MA, USA.
المصدر: BMC cancer [BMC Cancer] 2024 Mar 27; Vol. 24 (1), pp. 389. Date of Electronic Publication: 2024 Mar 27.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: BioMed Central Country of Publication: England NLM ID: 100967800 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2407 (Electronic) Linking ISSN: 14712407 NLM ISO Abbreviation: BMC Cancer Subsets: MEDLINE
أسماء مطبوعة: Original Publication: London : BioMed Central, [2001-
مواضيع طبية MeSH: Melanoma*/drug therapy , Skin Neoplasms*/drug therapy, Humans ; Proto-Oncogene Proteins B-raf/genetics ; Retrospective Studies ; Mitogen-Activated Protein Kinase Kinases
مستخلص: Background: The objective of this study was to describe real-world adjuvant therapy (AT) use by disease substage and assess determinants of treatment choice among patients with stage III melanoma.
Methods: This non-interventional retrospective study included survey responses and data from patient records provided by US medical oncologists. Survey responses, patient demographic/clinical characteristics, treatment utilization, and reasons for treatment were reported descriptively. The association between patient and disease characteristics and AT selection was assessed using logistic and multinomial regression models, overall and stratified by AJCC8 substage (IIIA vs. IIIB/C/D) and type of AT received (anti-PD1 monotherapy, BRAF/MEK, no AT), respectively.
Results: In total 152 medical oncologists completed the survey and reviewed the charts of 507 patients (168 stage IIIA; 339 stages IIIB/IIIC/IIID); 405 (79.9%) patients received AT (360/405 (88.9%) received anti-PD1 therapy; 45/405 (11.1%) received BRAF/MEK therapy). Physicians reported clinical guidelines (61.2%), treatment efficacy (37.5%), and ECOG performance status (31.6%) as drivers of AT prescription. Patient-level data confirmed that improving patient outcomes (79%) was the main reason for anti-PD1 prescription; expected limited treatment benefit (37%), patient refusal (36%), and toxicity concerns (30%) were reasons for not prescribing AT. In multivariable analyses stage IIIB/IIIC/IIID disease significantly increased the probability of receiving AT (odds ratio [OR] 1.74) and anti-PD1 therapy (OR 1.82); ECOG 2/3 and Medicaid/no insurance decreased the probability of AT receipt (OR 0.37 and 0.42, respectively) and anti-PD1 therapy (OR 0.41 and 0.42, respectively) among all patients and patients with stage IIIA disease.
Conclusion: Most patients were given AT with a vast majority treated with an anti-PD1 therapy. Physician- and patient-level evidence confirmed the impact of disease substage on AT use, with stage IIIA patients, patients without adequate insurance coverage, and worse ECOG status having a lower probability of receiving AT.
(© 2024. The Author(s).)
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فهرسة مساهمة: Keywords: Adjuvant therapy; Determinants of treatment choice; Stage III melanoma
المشرفين على المادة: EC 2.7.11.1 (Proto-Oncogene Proteins B-raf)
EC 2.7.12.2 (Mitogen-Activated Protein Kinase Kinases)
تواريخ الأحداث: Date Created: 20240328 Date Completed: 20240329 Latest Revision: 20240330
رمز التحديث: 20240330
مُعرف محوري في PubMed: PMC10967219
DOI: 10.1186/s12885-024-12178-w
PMID: 38539148
قاعدة البيانات: MEDLINE
الوصف
تدمد:1471-2407
DOI:10.1186/s12885-024-12178-w