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Shah S, Raskin L, Cohan D, Freeman M, Hamid O. Treatment patterns of malignant melanoma in the United States from 2011 to 2016: a retrospective cohort study. Curr Med Res Opin 2020; 36:63-72. [PMID: 31469305 DOI: 10.1080/03007995.2019.1662688] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Background: Since 2011, the approval of several new agents has improved treatment options for malignant melanoma. We describe treatment patterns for malignant melanoma in the United States from the MarketScan database from 2011 to 2016.Methods: Treatments used for patients aged >18 years diagnosed with malignant melanoma after January 1, 2011 and enrolled in the Truven MarketScan database were analyzed. Patient data were collected for the 12-month period from the date of the first melanoma diagnosis to either death, the pre-specified study end date (August 31, 2016), or date of termination of health insurance. Treatment patterns from 2011-2013 and 2014-2016 were analyzed according to agent, year of drug administration, and line of therapy.Results: From 2011 to 2016, use of cytokines (63.8; 13.3%) and chemotherapy (19.6; 12.9%) decreased, and use of checkpoint inhibitors increased (2.0; 49.9%). Checkpoint inhibitor use also increased across all lines of therapy from 2011-2013 and 2014-2016. Use of BRAF/MEK inhibitors remained relatively stable from 2011 to 2016 (6.5-12.5%); however, the use of vemurafenib monotherapy decreased (6.5; 0.8%), and treatment with combination regimens increased (0; 10.9%) from 2011-2016. BRAF/MEK inhibitor use only increased in the first line setting from 2011-2013 (9.7%) to 2014-2016 (11.2%).Conclusion: With the approval of immune checkpoint inhibitors, BRAF/MEK inhibitors, and targeted therapies, the therapeutic landscape for the treatment of metastatic melanoma has shifted dramatically away from cytokines and chemotherapy. Treatment patterns will likely continue to evolve as scientific advances are made.
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Affiliation(s)
- Shweta Shah
- Global Health Economics, Amgen Inc., Thousand Oaks, CA, USA
| | - Leon Raskin
- Center for Observational Research, Amgen Inc., Thousand Oaks, CA, USA
| | - David Cohan
- Medical Affairs, Amgen Inc., Thousand Oaks, CA, USA
| | | | - Omid Hamid
- The Angeles Clinic and Research Institute, Los Angeles, CA, USA
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Shah S, Raskin L, Cohan D, Hamid O, Freeman ML. Treatment patterns of melanoma by BRAF mutation status in the USA from 2011 to 2017: a retrospective cohort study. Melanoma Manag 2019; 6:MMT31. [PMID: 31871620 PMCID: PMC6920746 DOI: 10.2217/mmt-2019-0013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 10/03/2019] [Indexed: 12/15/2022] Open
Abstract
AIM To describe treatment changes from 2011 to 2017 and demographic/clinical characteristics of patients with advanced melanoma who received systemic therapy by BRAF status. PATIENTS & METHODS Treatment patterns were evaluated in adults from the Oncology Services Comprehensive Electronic Records database who received antimelanoma systemic therapy. RESULTS Checkpoint inhibitors were prevailingly prescribed (66%); usage increased from 2011 (21%) to 2017 (84%). BRAF/MEK inhibitors were the second most common (21%); usage increased from 2011 (6%) to 2012 (18%) and stabilized until 2017 (22%). BRAF/MEK inhibitors (65%) and checkpoint inhibitors (57%) were predominantly used for BRAFMut melanoma. CONCLUSION Overall, checkpoint inhibitors have supplanted other therapies for advanced melanoma. Treatment shifts have occurred for BRAFMut melanoma, notably increased use of checkpoint inhibitors and BRAF/MEK combinations compared with monotherapies.
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Affiliation(s)
- Shweta Shah
- Global Health Economics, Amgen Inc., Thousand Oaks, CA, USA
| | - Leon Raskin
- Center for Observational Research, Amgen Inc., Thousand Oaks, CA, USA
| | - David Cohan
- Medical Affairs, Amgen Inc., Thousand Oaks, CA, USA
| | - Omid Hamid
- The Angeles Clinic & Research Institute, Los Angeles, CA, USA
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Dacarbazine nanoparticle topical delivery system for the treatment of melanoma. Sci Rep 2017; 7:16517. [PMID: 29184162 PMCID: PMC5705606 DOI: 10.1038/s41598-017-16878-1] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Accepted: 11/17/2017] [Indexed: 01/08/2023] Open
Abstract
Dacarbazine (DZ) is poorly soluble in water with the short half-life in blood circulation, low rate of response with the toxic effect which ultimately limits its utilization of the treatment of skin cancer. In view of this background current study was designed for development of dacarbazine laden nanoparticle (DZNP) and dacarbazine laden nanocream (DZNC) topical delivery system for the treatment of melanoma. Firstly DZNP was prepared. By using DZNP its cream formulation prepared for topic drug delivery for melanoma. Dacarbazine nanoparticle and its cream were evaluated for morphology, drug load capacity, efficiency of nanoencapsulation and size of particle and zeta potential, Transmission Electron Microscopy (TEM), determination of pH, spreadability and viscosity, in vitro drug release capacity and its cytotoxic potential. The particle size of DZNP and DZNC was 16.3 ± 8.1 nm and 16.9 ± 7.8 nm respectively. pH value and spreadability of nanoparticle cream were found to be 6.7 ± 0.14 g cm/sec and 55.23 ± 3.13 g cm/sec respectively. Nanoencapsulation efficiency and Drug loading capacity were 67.4 ± 3.5% and 6.73 mg/10 mg respectively. IC50 of dacarbazine nanoparticle was 0.19 mg/ml while it was 0.63 mg/ml for nanoparticle cream. It can be concluded that DZNP and its cream can be effectively used as a topical formulation for the treatment of melanoma.
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Guan X, Wang H, Ma F, Qian H, Yi Z, Xu B. The Efficacy and Safety of Programmed Cell Death 1 and Programmed Cell Death 1 Ligand Inhibitors for Advanced Melanoma: A Meta-Analysis of Clinical Trials Following the PRISMA Guidelines. Medicine (Baltimore) 2016; 95:e3134. [PMID: 26986169 PMCID: PMC4839950 DOI: 10.1097/md.0000000000003134] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
The purpose of this study was to investigate the efficacy and safety of programmed cell death 1 (PD-1) and programmed cell death 1 ligand (PD-L1) inhibitors using a meta-analysis of present trials for advanced melanoma. A fully recursive literature search of the primary electronic databases for available trials was performed. The objective response rate (ORR) and the median progression-free survival (PFS) of clinical responses were considered the main endpoints to evaluate the efficacy, whereas Grade 3-4 adverse effects (AEs) were analyzed to evaluate safety. The ORR of PD-1 and PD-L1 inhibitors was 30% (95% CI: 25-35%). No significant difference in the ORR was observed after the comparisons of low-dose, median-dose, and high-dose cohorts. In addition, the rate of Grade 3-4 AEs was 9% (95% CI: 6-12%). According to the 3 randomized controlled trials that compared PD-1 inhibitors with chemotherapy, the difference between these 2 groups was found to be statistically significant with respect to the ORR, PFS and the incidence of Grade 3-4 AEs; that is, the relative risk (RR) of the ORR was 3.42 (95% CI: 2.49-4.69, P < 0.001), the hazard ratio (HR) of the PFS was 0.50 (95% CI: 0.44-0.58, P < 0.001), and the RR of Grade 3-4 AEs was 0.45 (95% CI: 0.31-0.65, P < 0.001). According to a meta-analysis of limited concurrent studies, PD-1 and PD-L1 inhibitors appear to be associated with improved response rates, superior response durability and tolerable toxicity in patients with advanced melanoma.
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Affiliation(s)
- Xiuwen Guan
- From the Department of Medical Oncology (XG, FM, ZY, BX), and State Key Laboratory of Molecular Oncology (HW, HQ), Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Frakes JM, Strom TJ, Naghavi AO, Trotti A, Rao NG, McCaffrey JC, Otto KJ, Padhya T, Caudell JJ. Outcomes of mucosal melanoma of the head and neck. J Med Imaging Radiat Oncol 2015; 60:268-73. [PMID: 26597431 DOI: 10.1111/1754-9485.12404] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Accepted: 09/17/2015] [Indexed: 01/02/2023]
Abstract
INTRODUCTION Mucosal melanoma of the head and neck is a rare disease with limited data available on outcomes; therefore, we reviewed our institutional experience. METHODS An institutional database was queried and 38 patients with head and neck mucosal melanoma were identified. Charts were abstracted and local control (LC), progression-free survival (PFS) and overall survival (OS) were calculated. RESULTS Most patients had T4 disease (86%), although nodes were positive in 11%. En bloc or endoscopic resection was performed on 93%. Adjuvant or definitive radiotherapy to a median dose of 60 Gy was utilized in 90%. Chemotherapy was given in 21%, and 16% received interferon. Three-year LC, PFS and OS were 90%, 48% and 59%, respectively. Median OS was 4.6 years. Site of first failure was distant in 52% of cases. CONCLUSION With aggressive therapy median OS was 4.6 years in this cohort. Distant recurrence remains the primary mode of failure. It may be reasonable to include mucosal melanoma patients in trials of systemic agents along with high-risk cutaneous melanomas.
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Affiliation(s)
- Jessica M Frakes
- Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Tobin J Strom
- Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Arash O Naghavi
- Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Andy Trotti
- Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Nikhil G Rao
- Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Judith C McCaffrey
- Department of Head and Neck and Endocrine Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Kristen J Otto
- Department of Head and Neck and Endocrine Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Tapan Padhya
- Department of Head and Neck and Endocrine Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Jimmy J Caudell
- Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
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Aghebati Maleki R, Shanehbandi D, Sadigh Eteghad S, Zarredar H, Zare Shahneh F, Aghebati Maleki L, Samavati M, Asadi H, Mosavi SE, Habibzadeh A, Mohammadian M, Baradaran B. Effects of some natural immunomodulatory compounds in combination with thalidomide on survival rate and tumor size in fibrosarcoma-bearing mice. Adv Pharm Bull 2014; 4:465-70. [PMID: 25364664 DOI: 10.5681/apb.2014.069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2014] [Revised: 06/14/2014] [Accepted: 06/18/2014] [Indexed: 11/17/2022] Open
Abstract
PURPOSE Despite significant advances have been achieved in cancer therapy, response to conventional treatments like surgery, radiotherapy and chemotherapy varies among individuals. Immunotherapy is known to be an effective strategy for patients who are resistant to the currently available interventions. METHODS Ninety-six male Balb/c mice (aged 6-8 weeks) were selected and divided into twelve groups of eight. Approximately, 1×10(6)of WEHI-164 cells were injected to each mouse for tumor genesis. Five immunotherapy treatments were considered in this study, including Heat Shock Proteins (HSP), Bacillus Calmette-Guérin (BCG), Bifidobacterium, Immuno-Modulator Drug (IMOD) and Thalidomide. After tumor formation, the groups were treated with one or more of these therapies. Tumor size and survival rate was regularly monitored. RESULTS Depending on the treatment group, tumor sizes were different. In some groups, combined treatments demonstrated more inhibitory effects on tumor growth rate. The mice in group (IMOD+ Thalidomide) had the lowest survival rate but group (BCG+ HSP+ Thalidomide) survived until the end of the experiment. CONCLUSION The (HSP+ BCG+ Thalidomide) group exhibited satisfactory outcomes and two third of the mice in this group went into complete remission. Some combination therapies in test groups had significant impacts on survival and tumor growth rate.
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Affiliation(s)
- Reza Aghebati Maleki
- Hematology and Oncology Research Center, Tabriz University of Medical sciences, Tabriz, Iran
| | - Dariush Shanehbandi
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Saeed Sadigh Eteghad
- Neurosciences Research Center (NSRC), Tabriz University of Medical Sciences, Tabriz, Iran
| | - Habib Zarredar
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | | | - Mehrnosh Samavati
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hamed Asadi
- Hematology and Oncology Research Center, Tabriz University of Medical sciences, Tabriz, Iran
| | - Seyed Ehsan Mosavi
- Hematology and Oncology Research Center, Tabriz University of Medical sciences, Tabriz, Iran
| | - Afshin Habibzadeh
- Hematology and Oncology Research Center, Tabriz University of Medical sciences, Tabriz, Iran
| | - Mozhdeh Mohammadian
- Amol Faculty of Paramedical Sciences, Mazandaran University of Medical Sciences, Sari, Iran
| | - Behzad Baradaran
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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