PCN158 - Real-World Comparison of Metastatic Melanoma Treatments between Academic and Community Hospitals in Canada: A Retrospective Study

Abstract

To compare metastatic melanoma drug treatment between academic and community hospitals in Canada using real-world data. This retrospective observational study utilized IMS Brogan Real-World Oncology Data, an anonymised patient database collected direct from specialists via electronic questionnaire spanning all relevant treatments and patient metrics. Drug regimens and hospital type (academic vs. community) of stage IV melanoma patients, treated in Canada between October 2014 and September 2015, were identified. Out of 430 patients, 293 (68%) were treated in an academic hospital, while 137 (32%) received therapy in a community setting. Out of 293 patients receiving therapy in academic hospitals, 139 patients (47%) were treated with immunotherapy (ipilimumab, pembrolizumab, IL-2 and interferon α-2b), 70 patients (24%) with targeted therapy (vemurafenib, dabrafenib and trametinib) and 84 patients (29%) with chemotherapy (all other antineoplastic drugs). 110 patients (38%) were treated with ipilimumab-based regimens while 48 patients (16%) used dacarbazine-based regimens. Out of 137 patients receiving therapy in the community setting, 33 patients (24%) were treated with immunotherapy, 48 patients (35%) with targeted therapy and 56 patients (41%) with chemotherapy. 25 patients (18%) were treated with ipilimumab-based regimens while 43 patients (31%) used dacarbazine-based regimens. The landscape in metastatic melanoma is now dominated by immunotherapy and targeted therapy. The majority of patients are treated in an academic setting. However, the real-world data used in this analysis has demonstrated differences in therapies between academic and community hospitals. Immunotherapy, led by ipilimumab-based regimens, is more common in academic hospitals than in the community setting (p<0.01). While on the other hand, chemotherapy, which is driven by dacarbazine-based regimens, is more prevalent in the community setting than in academic hospitals (p<0.01).