OBJECTIVES

: Real-world melanoma clinical practice is changing rapidly with the introduction of new treatments. This analysis examined patient-reported treatment patterns for melanoma in UK real-world practice, including choice and duration of treatment, consultation frequency, and application of treatment guidelines, in close to real-time.

METHODS

: Adults with any type or stage of melanoma were recruited to an observational study exploring the real-world impact of melanoma, conducted in collaboration with the patient advocacy group Melanoma UK. Data were collected via a bespoke ‘bring your own device’ app co-created with patients and Melanoma UK. Informed consent was obtained via the app, and ethical approval was obtained. Participants answered one-time questions relating to treatment patterns: current and previous treatments (drugs and surgery), where they lived/were treated, and frequency of consultations. Data were analyzed using R software; statistical analysis aimed to identify associations between treatment and other patient characteristics, including demographics and Eastern Cooperative Oncology Group (ECOG) performance status. Treatment patterns were compared with current guidelines.

RESULTS

: Of the 219 (total registered: 396) patients who specified current disease stage, 45% were stage 3 or 4; 83% reported a latest ECOG performance status of unknown or 0. Current real-world treatment of melanoma in the UK was broadly consistent with published guidance; immunotherapies dominated treatment at stage 4 (ipilimumab 35% patients; nivolumab 23% patients). 178 patients provided their location, allowing regional differences in treatment patterns to be identified. Radiotherapy was more common in North- (16% of patients) and South-West (14% of patients) regions, but was not used to treat any patients in the East Midlands and South-Central regions. Centers treating the most patients included the Christie, Royal Marsden and Nottingham Hospitals NHS Trusts.

CONCLUSIONS

: Melanoma treatment in the UK real-world setting broadly follows published guidelines. Availability of close to real-time data offers the opportunity to quickly identify any inequalities, improving care.