Real-world clinical outcomes of anticancer treatments in patients with advanced melanoma in China: retrospective, observational study

Abstract

Introduction: Treatment options for advanced melanoma in China are lacking, particularly second-line therapies. The aim of this retrospective observational study was to describe the real-world effectiveness of available anticancer therapies in patients with locally advanced/metastatic melanoma in China. Methods: Adult patients with unresectable stage III or IV melanoma treated between January 1, 2014, and December 31, 2015, at the Beijing Cancer Hospital (BCH) were eligible (data cutoff: December 31, 2017). Data were obtained from patient electronic medical records. Responders were adjudicated per Response Evaluation Criteria in Solid Tumors, version 1.1. Progression-free survival (PFS) and overall survival (OS) were estimated using the Kaplan-Meier method. Results: Of 248 eligible patients, 221 and 116 were treated with anticancer therapies in first-line and second-line settings, respectively (89 received both at BCH). Approximately 95% of patients had stage IV melanoma; 40.7% had acral melanoma, and 30.6% had mucosal histology. By data cutoff, 195 of 248 (78.6%) patients had died. Median OS for all patients was 10.5 months; 12-month OS rate was 43.9%. In the first-line setting, the objective response rate was 6.3% (95% confidence interval, 3.5%–10.4%) and the median duration of response was 9.1 months. Median PFS was 3.5 months and 12-month PFS rate was 10.6%; median OS was 10.5 months and 12-month OS rate was 43.5%. In the second-line setting, objective response rate was 3.4% (95% confidence interval, 0.9%–8.6%) and median duration of response was 7.5 months. Median PFS was 2.3 months and 12-month PFS rate was 5.2%; median OS was 7.5 months and 12-month OS rate was 30.5%. Conclusion: In China, first-line and second-line anticancer therapy seems to be associated with suboptimal clinical outcomes in advanced melanoma, indicating a need for effective therapies.