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Thiem A, Mashhadiakbar P, Cussigh C, Hassel JC, Grimmelmann I, Gutzmer R, Schlaak M, Heppt MV, Dücker P, Hüning S, Schulmeyer L, Schilling B, Haferkamp S, Ziemer M, Moritz RKC, Hagelstein V, Terheyden P, Posch C, Gaiser MR, Kropp P, Emmert S, Müller B, Tietze JK. Immune checkpoint inhibition and targeted therapy for melanoma: A patient‐oriented cross‐sectional comparative multicenter study. J Eur Acad Dermatol Venereol 2022; 37:884-893. [PMID: 36433671 DOI: 10.1111/jdv.18778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 11/08/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Choosing the adequate systemic treatment for melanoma is driven by clinical parameters and personal preferences. OBJECTIVE Evaluation of the impact of disease and treatment on the daily life of patients receiving systemic therapy for melanoma. METHODS A German-wide, cross-sectional comparative study was conducted at 13 specialized skin cancer centres from 08/2020 to 03/2021. A questionnaire was distributed to assess patients' perception of disease and symptoms, the impact of their current treatment on quality of life (QOL) and activities, adverse events (AEs), therapeutic visits, as well as believe in and satisfaction with their current systemic melanoma treatment. Patient-reported outcomes (PROs) were rated on a continuous numerical rating scale or selected from a given list. RESULTS Four hundred and fourteen patients with systemic melanoma therapy were included. 359 (87%) received immune checkpoint inhibition (ICI) and 55 (13%) targeted therapy (TT). About 1/3 of patients were adjuvantly treated, the remaining because of unresectable/metastatic melanoma. In subgroup analyses, only in the adjuvant setting, TT patients reported a significant decrease in their treatment associated QOL compared to patients with ICI (p = 0.02). Patients with TT were 1.9 times more likely to report AEs than patients with ICI, a difference being significant just for the adjuvant setting (p = 0.01). ICI treatment intervals differed significantly between adjuvant and unresectable/metastatic setting (p = 0.04), though all patients, regardless of their specific ICI drug, evaluated their treatment frequency as adequate. TT patients with dabrafenib/trametinib (n = 37) or encorafenib/binimetinib (n = 15) did not differ regarding the strain of daily pill intake. Patients older than 63 years rated various PROs better than younger patients. CONCLUSIONS Patients evaluated their treatment mainly positively. ICI might be preferred over TT regarding QOL and patient-reported AEs in the adjuvant setting. Older melanoma patients appeared to be less impacted by their disease and more satisfied with their treatment.
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Affiliation(s)
- A. Thiem
- Clinic and Policlinic for Dermatology and Venereology University Medical Center Rostock Rostock Germany
| | - P. Mashhadiakbar
- Clinic and Policlinic for Dermatology and Venereology University Medical Center Rostock Rostock Germany
| | - C. Cussigh
- Department of Dermatology and National Center for Tumor Diseases (NCT) Heidelberg University Hospital Heidelberg Germany
| | - J. C. Hassel
- Department of Dermatology and National Center for Tumor Diseases (NCT) Heidelberg University Hospital Heidelberg Germany
| | - I. Grimmelmann
- Skin Cancer Center Hannover, Department of Dermatology Hannover Medical School Hannover Germany
| | - R. Gutzmer
- Skin Cancer Center Hannover, Department of Dermatology Hannover Medical School Hannover Germany
- Skin Cancer Center Minden, Department of Dermatology, Johannes‐Wesling‐Klinikum Minden/Ruhr‐University, Bochum Minden Germany
| | - M. Schlaak
- Department of Dermatology and Allergy University Hospital of Munich (LMU) Munich Germany
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu Berlin, Department of Dermatology, Venereology and Allergology Berlin Germany
| | - M. V. Heppt
- Department of Dermatology and Comprehensive Cancer Center Erlangen‐European Metropolitan Area of Nuremberg (CCC ER‐EMN), Universitätsklinikum Erlangen, Friedrich‐Alexander‐University Erlangen‐Nürnberg Erlangen Germany
| | - P. Dücker
- Department of Dermatology, Hospital of Dortmund Dortmund Germany
| | - S. Hüning
- Department of Dermatology, Hospital of Dortmund Dortmund Germany
| | - L. Schulmeyer
- Department of Dermatology, Venereology and Allergology University Hospital Würzburg Würzburg Germany
| | - B. Schilling
- Department of Dermatology, Venereology and Allergology University Hospital Würzburg Würzburg Germany
| | - S. Haferkamp
- Department of Dermatology University Hospital Regensburg Regensburg Germany
| | - M. Ziemer
- Department of Dermatology, Venereology and Allergology University Medical Center Leipzig Leipzig Germany
| | - R. K. C. Moritz
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu Berlin, Department of Dermatology, Venereology and Allergology Berlin Germany
- Department of Dermatology and Venereology, Martin‐Luther‐University Halle‐Wittenberg Halle (Saale) Germany
| | - V. Hagelstein
- Department of Dermatology, Allergology, and Venereology University of Lübeck Germany
| | - P. Terheyden
- Department of Dermatology, Allergology, and Venereology University of Lübeck Germany
| | - C. Posch
- Department of Dermatology, Venereology and Allergology, Clinic Hietzing Vienna Healthcare Group Vienna Austria
- Department of Dermatology and Allergy, School of Medicine, German Cancer Consortium (DKTK) Technical University of Munich Munich Germany
- Faculty of Medicine Sigmund Freud University Vienna Vienna Austria
| | - M. R. Gaiser
- Department of Dermatology, Venerology and Allergology, Medical Faculty Mannheim, University Medical Center Mannheim Heidelberg University Mannheim Germany
- Skin Cancer Unit, German Cancer Research Center (DKFZ), Heidelberg Germany
| | - P. Kropp
- Institute of Medical Psychology and Medical Sociology University Medical Center Rostock Rostock Germany
| | - S. Emmert
- Clinic and Policlinic for Dermatology and Venereology University Medical Center Rostock Rostock Germany
| | - B. Müller
- Institute of Medical Psychology and Medical Sociology University Medical Center Rostock Rostock Germany
| | - J. K. Tietze
- Clinic and Policlinic for Dermatology and Venereology University Medical Center Rostock Rostock Germany
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Becker J, Ugurel S, Leiter-Stoppke U, Meier F, Gutzmer R, Haferkamp S, Zimmer L, Livingstone E, Eigentler T, Hauschild A, Kiecker F, Hassel J, Mohr P, Fluck M, Thomas I, Garzarolli M, Grimmelmann I, Drexler K, Eckhardt S, Schadendorf D. 787O Adjuvant immunotherapy with nivolumab (NIVO) versus observation in completely resected Merkel cell carcinoma (MCC): Disease-free survival (DFS) results from ADMEC-O, a randomized, open-label phase II trial. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Gutzmer R, Eigentler T, Mohr P, Weichenthal M, Dücker P, Gebhardt C, Göppner D, Grimmelmann I, Haferkamp S, Kähler K, Meier F, Pföhler C, Sickmann T, Sindrilaru A, Terheyden P, Ugurel S, Ulrich J, Utikal J, Weishaupt C, Schadendorf D. 1079P Comparison of effectiveness and safety of nivolumab monotherapy or in combination therapy with ipilimumab in therapy-naïve and pretreated patients with advanced melanoma within the German noninterventional study NICO. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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