Time to first-line (1L) therapy discontinuation in metastatic melanoma (MM).

Abstract

196 Background: Nivolumab or pembrolizumab monotherapy (N/P) and dabrafenib+trametinib combination therapy (D+T) are currently the most commonly used regimens for the treatment of MM in anti-PD1 and BRAF inhibitor classes, respectively. We describe time to discontinuation of 1L therapy with N/P or D+T in patients (pts) with MM in a real-world setting. Methods: Adults with MM initiated on N/P or D+T in 1L were identified in Truven MarketScan databases (Q1/2014 - Q2/2016; n = 443). Outcomes included (a) distribution of time to 1L discontinuation among pts who discontinued 1L therapy during the study follow-up (reported by year of 1L start) and (b) rates of pts still on 1L therapy at different time points after 1L therapy start ("on treatment" rates) estimated from Kaplan-Meier analyses. Results: Of 443 pts, 243 (55%) were initiated on N/P and 200 (45%) on D+T. Pts initiated on D+T appeared to be younger, with more brain metastases, and higher use of emergency care in the 6 mo prior to 1L therapy start as compared to those initiated on N/P (Table). Time to 1L discontinuation and "on treatment" rates were similar between the treatment groups, with a tendency towards longer time to 1L discontinuation for D+T (Table). Conclusions: This real-world data study showed numerically longer time to 1L discontinuation for pts treated with D+T as compared to N/P, despite higher comorbidity burden. [Table: see text]