Treatment Use and Overall Survival of Patients with Unresectable/Metastatic Melanoma in Colombia: A Real World Study

OBJECTIVES: This study aimed to measure treatment use and overall survival (OS) of Colombian patients with unresectable/metastatic melanoma between 2015 to 2022.

METHODS: A descriptive, retrospective, longitudinal cohort study was conducted in patients with the diagnosis of unresectable and metastatic melanoma in the Colombian population using electronic health record and pharmacy claims databases of a Health Management Organization (HMO). The period of study will be from 01 January 2015 to 31 December 2022. The index date is defined as the date of first or initial record of unresectable or metastatic melanoma diagnosis. Patients were followed from the index date until death, discontinuation of HMO insurance (patient loss), 5-year follow-up, or the end of the observation period (31 December 2022). Kaplan-meier survival analysis and Cox proportional hazards model were conducted.

RESULTS: 156 patients with unresectable/metastatic melanoma were included in the study. The mean of follow up were 25.9 months (Standard deviation [SD] 23.9). The median of overall survival of the total population was 67.8 months (95% Interval confidence IC 37.4 - no available [NA]). The patients older 60 years presented a median OS 35.7 months (95% IC 23.3 - NA) while younger patients did not achieve median. Clinical characteristics such as number of metastasis, comorbidities, high lactate dehydrogenase levels, localization of primary cancer can modify the general OS in the univariable analysis. The most frequent therapy used as first line were immunotherapy (84.7%). In these, nivolumab in monotherapy (57.6%) and nivolumab combined with ipilimumab (28.2%) the most prescribed. Target therapy was used in 10.8% as first line, and 33.3% en second line. 28.8% of patients were not treated with any treatment.

CONCLUSIONS: The OS observed in unresectable/metastatic melanoma in Colombian patients was affected by demographic and clinical characteristics of patients. The immunotherapy is main driver of treatment of patients with stage of melanoma.