OBJECTIVES: Significant advances were recently observed in the treatment of metastatic melanoma (MM). With 58% of patients now reaching a second line of treatment and a significant improvement in survival, the assessment of quality of life (QoL) during whole disease is necessary. The objective of this work is to evaluate the impact of the disease progression and of the treatment line on the QoL evolution in real clinical practice.

METHODS: QoL is collected through MelBase, a prospective French multicentric cohort dedicated to the follow-up of adults with MM. QoL is assessed using the EQ-5D and the FACT-M questionnaires, at inclusion, every 3 months and at each treatment change, until death. To assess longitudinal changes from baseline to the event (progression or 2nd line of treatment), mixed-effect models for repeated measures analysis were used that controlled for baseline covariates (sex and prognosis factor).

RESULTS: QoL is assessed on 1319 patients included between 2013 and 2017. Median follow-up is 10 months and 613 patients died during follow-up. From models, in 1st treatment line, the mean utility score is 0.827 [CI95%:0.815; 0.840] and 129.46 [128.02; 130.90] for FACT-M. In progression free survival (PFS) state, the mean utility score is 0.831 [0.819; 0.843] and 129.94 [128.54;131.34] for FACT-M. At the time of line change, there is a decrease of 0.019 [-0.04;0.00] and of 3.01 [-5.01;-0.95] respectively for utility and for FACT-M compared to the 1st treatment line. At the time of progression, there is a decrease of 0.031 [-0.05;-0.01] and of 4.58 [-6.61;-2.55] respectively for utility and FACT-M compared to PFS.

CONCLUSIONS: Based on filled in questionnaires, in Melbase cohort, MM patient’s QoL seems to be fairly stable during the 1st treatment line and PFS state. Similar trends are obtained in 2nd line of treatment and after progression. A drop is observed at the time of the event.