Harries Mark, Mohr Peter, Grange Florent, Ehness Rainer, Benjamin Laure, Siakpere Obukohwo, Barth Janina, Stapelkamp Ceilidh, Pfersch Sylvie, McLeod Lori, Wolowacz Sorrel, Kaye James A, Kontoudis Ilias
Department of Medical Oncology, Guy's and St Thomas's Hospitals NHS Foundation Trust, Guy's Hospital, London, UK.
Clinic of Dermatology, Elbekliniken Buxtehude, Buxtehude, Germany.
Int J Clin Pract. 2017 May;71(5). doi: 10.1111/ijcp.12946.
Real-world data on treatment patterns/outcomes in patients with advanced melanoma, while scarce, are useful for health technology assessments that govern patient access in many countries. We collected retrospective data on treatment patterns among patients in France, Germany and the UK with Stage IIIB/IIIC melanoma with macroscopic lymph node involvement, whose primary melanoma and regional lymph node metastases had been completely resected.
Patients ≥18 years were diagnosed between 1 January 2009 and 31 December 2011. Data were obtained from patients' medical records and a patient survey.
Forty-nine centres provided data on 558 patients: 53.6% had Stage IIIB disease; 58.2% were of working age (<65 years), 22.5% reported a change in employment status due to melanoma, 8% were on long-term sick leave; and 35.1% were deceased over the study period. Overall median distant metastases-free survival was 23.4 months and median disease-free survival was 13.3 months. Hospitalisation frequency increased during distant metastatic/terminal disease phases. Adjuvant therapy was received by 7.0% (14/199) of patients in France, 2.6% (5/195) in the UK, and 33.5% (55/164) in Germany. Low-dose interferon was used more frequently than other regimens. High-dose interferon was associated with discontinuation in 28.6% and dose delay/reduction in 33.3% of patients.
Rapid disease progression combined with increased use of healthcare resources in later phases of disease result in a high burden-of-illness for patients and healthcare providers. The use of adjuvant interferon therapy varies considerably in this population in the countries studied, highlighting the need for improved treatments for melanoma.
关于晚期黑色素瘤患者治疗模式/结果的真实世界数据虽然稀少，但对许多国家指导患者获得治疗的卫生技术评估很有用。我们收集了法国、德国和英国患有IIIB/IIIC期黑色素瘤且有宏观淋巴结受累、其原发性黑色素瘤和区域淋巴结转移已完全切除患者的治疗模式回顾性数据。
年龄≥18岁的患者于2009年1月1日至2011年12月31日期间被诊断。数据从患者的病历和患者调查中获得。
49个中心提供了558例患者的数据：53.6%患有IIIB期疾病；58.2%为工作年龄（<65岁），22.5%报告因黑色素瘤导致就业状况改变，8%长期病假；35.1%在研究期间死亡。总体远处转移无进展生存期的中位数为23.4个月，无病生存期的中位数为13.3个月。在远处转移/终末期疾病阶段住院频率增加。法国7.0%（14/199）的患者、英国2.6%（5/195）的患者以及德国33.5%（55/164）的患者接受了辅助治疗。低剂量干扰素的使用比其他方案更频繁。高剂量干扰素导致28.6%的患者停药，33.3%的患者剂量延迟/减少。
疾病快速进展加上疾病后期医疗资源使用增加，给患者和医疗服务提供者带来了高疾病负担。在所研究的国家中，这一人群辅助干扰素治疗的使用差异很大，凸显了改善黑色素瘤治疗的必要性。
