CURRENT TREATMENT PATTERNS IN NON-METASTATIC MELANOMA IN THE MODERN TREATMENT ERA: A SURVEILLANCE, EPIDEMIOLOGY, AND END RESULTS (SEER)-MEDICARE ANALYSIS
Author(s)
Leah B. Sansbury, PhD1, Marianne Cunnington, MSc, PhD2, Angela Lax, MPH3, Adina Zhang, MS4, Maral DerSarkissian, PhD5, Eden Ma, MS4, Alexandra Barry, MS4, Ahmad Tarhini, MD, PhD6.
1Moderna, Inc., Cambridge, MA, USA, 2Analysis Group, London, United Kingdom, 3Analysis Group, Inc., Denver, CO, USA, 4Analysis Group, Inc., Boston, MA, USA, 5Analysis Group, Inc., Los Angeles, CA, USA, 6Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
1Moderna, Inc., Cambridge, MA, USA, 2Analysis Group, London, United Kingdom, 3Analysis Group, Inc., Denver, CO, USA, 4Analysis Group, Inc., Boston, MA, USA, 5Analysis Group, Inc., Los Angeles, CA, USA, 6Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
OBJECTIVES: Given recent immunotherapy approvals for resectable melanoma, this study aimed to describe current real-world treatment patterns among older adults with non-metastatic melanoma in the United States, overall and by stage at diagnosis.
METHODS: Patients diagnosed with Stage I-III melanoma in SEER between January 2019 and December 2021 were linked to Medicare claims. Baseline characteristics were assessed during the 12-month pre-diagnosis period. Treatment patterns, including surgery, adjuvant therapy, and neoadjuvant therapy, were evaluated following diagnosis. Duration of adjuvant therapy was assessed using Kaplan-Meier methods.
RESULTS: A total of 5,483 patients with Stage I-III melanoma were identified, including 3,978 Stage I, 1,021 Stage II, and 484 Stage III patients. Mean age ranged from 75.7 years (Stage I) to 79.1 years (Stage II).
Surgery was the predominant treatment modality, received by 92.1%, 90.9%, and 89.3% of patients with Stage I, II, and III disease, respectively. Surgery alone was received by 89.7% of Stage I patients and 85.1% of Stage II patients, while 50.0% of Stage III patients received adjuvant therapy following surgery.
Neoadjuvant therapy was uncommon, occurring in 3.9% of Stage III patients with immunotherapy as the most common regimen (78.9%).
Among patients receiving adjuvant therapy, immunotherapy was the most frequently used treatment in both Stage IIB/C (63.2%) and Stage III disease (88.4%). In Stage III disease, nivolumab (47.9%) and pembrolizumab (34.7%) monotherapy were the most common adjuvant regimens.
Median adjuvant treatment duration was 12.6 months in Stage IIB/C and 11.5 months in Stage III disease.
CONCLUSIONS: Surgery remained the cornerstone of treatment for non-metastatic melanoma. Immunotherapy was the predominant adjuvant treatment among high-risk patients, particularly in Stage III disease, while neoadjuvant therapy was rarely used. Continued evaluation of treatment patterns is warranted following recent approvals and updated guidance for immunotherapy for patients with resectable cutaneous melanoma.
METHODS: Patients diagnosed with Stage I-III melanoma in SEER between January 2019 and December 2021 were linked to Medicare claims. Baseline characteristics were assessed during the 12-month pre-diagnosis period. Treatment patterns, including surgery, adjuvant therapy, and neoadjuvant therapy, were evaluated following diagnosis. Duration of adjuvant therapy was assessed using Kaplan-Meier methods.
RESULTS: A total of 5,483 patients with Stage I-III melanoma were identified, including 3,978 Stage I, 1,021 Stage II, and 484 Stage III patients. Mean age ranged from 75.7 years (Stage I) to 79.1 years (Stage II).
Surgery was the predominant treatment modality, received by 92.1%, 90.9%, and 89.3% of patients with Stage I, II, and III disease, respectively. Surgery alone was received by 89.7% of Stage I patients and 85.1% of Stage II patients, while 50.0% of Stage III patients received adjuvant therapy following surgery.
Neoadjuvant therapy was uncommon, occurring in 3.9% of Stage III patients with immunotherapy as the most common regimen (78.9%).
Among patients receiving adjuvant therapy, immunotherapy was the most frequently used treatment in both Stage IIB/C (63.2%) and Stage III disease (88.4%). In Stage III disease, nivolumab (47.9%) and pembrolizumab (34.7%) monotherapy were the most common adjuvant regimens.
Median adjuvant treatment duration was 12.6 months in Stage IIB/C and 11.5 months in Stage III disease.
CONCLUSIONS: Surgery remained the cornerstone of treatment for non-metastatic melanoma. Immunotherapy was the predominant adjuvant treatment among high-risk patients, particularly in Stage III disease, while neoadjuvant therapy was rarely used. Continued evaluation of treatment patterns is warranted following recent approvals and updated guidance for immunotherapy for patients with resectable cutaneous melanoma.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
HSD9
Topic
Health Service Delivery & Process of Care
Disease
Oncology