Outcomes for systemic therapy in older patients with metastatic melanoma: Results from the Dutch Melanoma Treatment Registry

Anouk Jochems*, Esther Bastiaannet, Maureen J.B. Aarts, Alexander C.J. van Akkooi, Franchette W.P.J. van den Berkmortel, Marye J. Boers-Sonderen, Alfonsus J.M. van den Eertwegh, Nienke G. de Glas, Jan Willem B. de Groot, John B.A.G. Haanen, Geke A.P. Hospers, Jacobus J.M. van der Hoeven, Djura Piersma, Rozemarijn S. van Rijn, Karijn P.M. Suijkerbuijk, Albert J. ten Tije, Astrid A.M. van der Veldt, Gerard Vreugdenhil, Michiel C.T. van Zeijl, Ellen KapiteijnMichel W.J.M. Wouters

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

2 Citations (Scopus)
9 Downloads (Pure)

Abstract

Background: The incidence of metastatic melanoma is increasing in all ages. Multiple trials with targeted drugs and immune checkpoint inhibitors showed improved survival in metastatic melanoma. However, patients aged ≥75 years are often under-represented in clinical trials, therefore raising questions on safety and efficacy of treatment. Patients and methods: We analyzed a real-world cohort of 3054 patients with metastatic melanoma stratified for age (≤65 years, 66–74 years and ≥ 75 years), and BRAF status, providing data on treatment strategies, toxicity, and survival. Kaplan Meier curves and Cox Proportional Hazard Models were used to present overall survival (OS) and Melanoma Specific Survival (MSS). Results: Overall, 52.2% of patients were ≤ 65 years and 18.4% of patients ≥75 years. BRAF mutated tumors were found less often in patients ≥75 years: 34.5% versus 65% in patients ≤65 years. Patients ≥75 years received systemic therapy less frequently compared to their younger counterparts independent of the BRAF status. When receiving treatment, no statistical significant difference in grade 3 or 4 toxicity was observed. Three year Overall Survival rate was 13.7% (9.1–19.3) in patients ≥75 years versus 26.7% (23.1–30.4) in patients ≤65 years, with a Hazard Ratio (HR) of 1.71 (95%CI 1.50–1.95), p < 0.001. Three year Melanoma Specific Survival was 30.4% (22.0–39.2) versus 34.0% (29.7–38.2), HR 1.26 (95% CI 1.07–1.49), p = 0.005 with an adjusted HR of 1.21 (1.00–1.47), p = 0.049. Conclusion: Patients with metastatic melanoma ≥75 years are less frequently treated, but when treated there is no statistical significant increase in toxicity and only a borderline statistical significant difference in Melanoma Specific Survival was seen, compared to younger patients.

Original languageEnglish
Pages (from-to)1031-1038
Number of pages8
JournalJournal of Geriatric Oncology
Volume12
Issue number7
DOIs
Publication statusPublished - 1 Sept 2021

Bibliographical note

Funding Information:
The Netherlands Organisation for Health Research and Development funded the start-up of the DMTR (grant number 836002002 ). This grant was awarded under the effectiveness research for high-cost medicine programme. From its foundation the DMTR was sponsored by BMS , GSK (later acquired by Novartis), Roche Nederland BV and MSD (from 2015). Roche Nederland B.V. stopped and Pierre Fabre started funding of the DMTR in 2019. This manuscript received no external funding.

Funding Information:
Conceptualization : Anouk Jochems (AJ), Esther Bastiaannet (EB), Ellen Kapiteijn (EK), Michel W.J.M Wouters (MW), Jacobus J.M. van der Hoeven (JvdH). Data curation : Anouk Jochems (AJ), Esther Bastiaannet (EB), Ellen Kapiteijn (EK), Michel W.J.M Wouters (MW), Jacobus J.M. van der Hoeven (JvdH), Maureen J.B Aarts (MA), Franchette W.P.J. van den Berkmortel (FB), Marye J. Boers-Sonderen (MB), Alfonsus J.M. van den Eertwegh (AE), Nienke A. de Glas (NG), Jan Willem B. de Groot (JG), John B.A.G. Haanen (JH), Geke A.P. Hospers (GH), Djura Piersma (DP), Rozemarijn S. van Rijn (RR), Karijn P.M. Suijkerbuijk (KS), Albert Jan ten Tije (AT), Astrid A.M. van der Veldt (AV), Gerard Vreugdenhil (GV), Michiel C.T. van der Zeijl (MZ). Formal analysis : Anouk Jochems (AJ), Esther Bastiaannet (EB), Ellen Kapiteijn (EK), Michel W.J.M Wouters (MW), Jacobus J.M. van der Hoeven (JvdH). Funding acquisition : None for this article in particular. The DMTR was funded with a grant from the Netherlands Organization for Health Research and Development. Investigation : Anouk Jochems (AJ), Esther Bastiaannet (EB), Ellen Kapiteijn (EK), Michel W.J.M Wouters (MW), Jacobus J.M. van der Hoeven (JvdH). Methodology : Anouk Jochems (AJ), Esther Bastiaannet (EB), Ellen Kapiteijn (EK), Michel W.J.M Wouters (MW), Jacobus J.M. van der Hoeven (JvdH). Project administration : Anouk Jochems (AJ). Resources : The Dutch Melanoma Treatment Registry. Software : STATA/SE (version 12.0, Statacorp LP, Texas, USA). Supervision : Ellen Kapiteijn (EK), Michel W.J.M Wouters (MW), Jacobus J.M. van der Hoeven (JvdH). Validation : the manuscript has been reviewed and approved by all co- authors. Visualization : Anouk Jochems (AJ), Esther Bastiaannet (EB). Writing Original Draft : Anouk Jochems (AJ), Esther Bastiaannet (EB), Ellen Kapiteijn (EK), Michel W.J.M Wouters (MW), Jacobus J.M. van der Hoeven (JvdH). Writing review & editing : the manuscript has been reviewed and approved by all co-authors. The first author (AJ) edited all feedback and changes.

Publisher Copyright:
© 2021 The Authors

Fingerprint

Dive into the research topics of 'Outcomes for systemic therapy in older patients with metastatic melanoma: Results from the Dutch Melanoma Treatment Registry'. Together they form a unique fingerprint.

Cite this