Medical Oncology, Hospital General Universitario Gregorio Marañón, Calle Dr. Esquerdo 46, 28007, Madrid, Spain.
CIBERONC, Madrid, Spain.
Clin Transl Oncol. 2019 Dec;21(12):1754-1762. doi: 10.1007/s12094-019-02201-z. Epub 2019 Aug 21.
To describe patient characteristics by disease stage, resectability status and current treatment management after first diagnosis of IIIB to IV1c advanced (AM)/metastatic melanoma (MM).
METHODS/PATIENTS: Multicentre, retrospective study based on data from medical charts of patients > 18 years at MM first diagnosis, visited by oncologists at 4 reference centres in Spain: Hospital Universitario Gregorio Marañón (Madrid), Hospital General de Valencia (Valencia), Clínica Universidad de Navarra (Pamplona), and Hospital Clínic (Barcelona).
Metastatic non-visceral melanoma (IIIB, IIIC, IV M1a) was reported in 139 (48.6%) patients and 40.9% (n = 117) were diagnosed with IV-M1c disease. 160 (55.9%) metastases were resectable. Available therapies under clinical practice were used in 210 patients; 74 were treated under clinical trials (CT). Intention-to-cure surgery (47.6%) was the most common treatment at time of MM diagnosis. Systemic (45.1% overall) therapy included chemo-, targeted- and immunotherapy (19.6%, 14.3%, 8.4%, respectively). At time of data collection, 26 patients were still alive and 120 had progressed to IV-M1c. Median overall survival (OS) was significantly larger in IIIB patients, 28.9 m (25.2-32.7); the shortest for IV-M1c patients, 11.0 m (8.7-13.3).
Novel treatments are undoubtedly a major step forward in AM/MM, however these are often only available in the CT setting because early stages of development or country-specific regulations. Further prospective studies and multifactorial analysis should be performed to clearly identify possible clinical associations for outcome in Spanish patients with AM/MM.
描述 IIIB 至 IV1c 期晚期（AM）/转移性黑色素瘤（MM）患者在首次诊断后的疾病阶段、可切除性状态和当前治疗管理情况。
方法/患者：这是一项基于西班牙 4 家参考中心的肿瘤科医生对首次 MM 诊断时年龄大于 18 岁的患者的病历数据进行回顾性研究。这些中心分别是马德里的 Gregorio Marañón 大学医院、巴伦西亚的 General 大学医院、潘普洛纳的纳瓦拉大学临床医院和巴塞罗那的 Clinic 医院。
报告了 139 例（48.6%）转移性非内脏黑色素瘤（IIIB、IIIC、IV M1a），其中 40.9%（n=117）诊断为 IV-M1c 疾病。160 例（55.9%）转移灶可切除。在 210 例患者中使用了临床实践中可用的治疗方法；74 例接受了临床试验（CT）治疗。在 MM 诊断时，最常见的治疗方法是意向治愈性手术（47.6%）。全身治疗（总体占 45.1%）包括化疗、靶向治疗和免疫治疗（分别为 19.6%、14.3%和 8.4%）。在数据收集时，26 例患者仍存活，120 例患者进展为 IV-M1c。IIIb 期患者的中位总生存期（OS）显著更长，为 28.9 个月（25.2-32.7）；IV-M1c 期患者的 OS 最短，为 11.0 个月（8.7-13.3）。
新型治疗方法无疑是 AM/MM 治疗的重大进步，但由于处于早期开发阶段或因国家特定法规，这些方法通常仅在 CT 环境中可用。应进一步进行前瞻性研究和多因素分析，以明确确定西班牙 AM/MM 患者的可能临床关联。
