Real Life Clinical Management and Survival in Advanced Cutaneous Melanoma: The Italian Clinical National Melanoma Registry Experience

Frontiers in Oncology

Giuseppe Mastrangelo¹  Carlo Riccardo Rossi¹  Michele Guida²  Federica Toffolutti³  Vincenzo De Giorgi⁴  Marcella Occelli⁵  Mario Budroni⁶  Giuseppe Palmieri⁷  Federica Grosso⁸  Giuseppe Cairo⁹  Alessandro Gatti^1,10  Daniela Massa^1,11  Laura Atzori^1,12  Nicola Calvani^1,13  Tommaso Fabrizio^1,14  Ignazio Stanganelli^1,15  Giovanna Moretti^1,15  Maria Antonietta Pizzichetta^1,15  Maddalena Cespa^1,15  Guido Zannetti^1,15  Salvatore Asero^1,15  Laura Milesi^1,15  Marilena Visini^1,15  Massimo Guidoboni^1,15  Caterina Ferreli^1,15  Franco Di Filippo^1,15  Giovanni Sanna^1,15  Lucia Lospalluti^1,15  Carlo Riberti^1,15  Leonardi Vita^1,15  Leonardo Zichichi^1,15  Gianmichele Moise^1,15  Saverio Cinieri^1,15  Maria Concetta Fargnoli^1,15  Annamaria Pollio^1,15  Giusto Trevisan^1,15  the Clinical National Melanoma Registry Study Group at the Italian Melanoma Intergroup^1,15  Luca Bianchi^1,15  Luigi Mascheroni^1,15  Riccardo Pellicano^1,15  Rosanna Barbati^1,15  Rosachiara Forcignanò^1,15  Maria Grimaldi^1,15  Maria Teresa Fierro^1,15  Francesca Bruder^1,15  Carmelo Iacono^1,15  Michele Maio^1,15  Stefania Staibano^1,15  Gaetana Rinaldi^1,15  Caterina Catricalà^1,15  Pietro Quaglino^1,16  Simone Ribero^1,16  Erika Giulioni^1,17  Maria Teresa Corradin^1,17  Alessandro Testori^1,18  Stefania Barruscotti^1,18  Francesco Spagnolo^1,19  Elisabetta Pennacchioli^2,20  Paola Queirolo^2,20  Giulio Tosti^2,20  Sara Gandini^2,20  Corrado Caracò^2,21  Egidio Celentano^2,21  Paolo A. Ascierto^2,21  Vito Vanella^2,21  Anna Crispo^2,21  Paolo Del Fiore^2,22  Antonella Vecchiato^2,22  Monica Giordano^2,23  Desire Marussi^2,23  Eleonora Nacchiero^2,24  Giuseppe Giudice^2,24 

[1] 0Dermatology Clinic, Università degli studi di Padova, Padova, Italy;0IRCCS Istituto Tumori “Giovanni Paolo II”, Bari, Italy;1Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano (PN), Italy;1Dermatology Department, Università di Firenze, Firenze, Italy;2Oncology Department, Azienda ospedaliera Santa Croce e Carle, Cuneo, Italy;2Registro Tumori Provincia di Sassari, Azienda Ospedaliera Universitaria Sassari, Sassari, Italy;3Istituto di Ricerca Genetica e Biomedica, CNR, Sassari, Italy;3Mesothelioma Unit, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy;4Oncology Department, ospedale “Vito Fazzi” di Lecce, Lecce, Italy;5ULSS 2 Marca Trevigiana Ospedale Ca’ Foncello Treviso, Treviso, Italy;6Gruppo melanoma e tumori rari, Oncology Department, PO A Businco ARNAS G. Brotzu, Cagliari, Italy;7Dermatology Clinic, Department Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy;8Oncology Department, Presidio Ospedaliero “Senatore Antonio Perrino”, Brindisi, Italy;9IRCCS Centro di Riferimento Oncologico Basilicata, Rionero in Vulture, Italy;;Clinica Dermatologica, Dipartimento di Scienze Mediche, Università di Torino, Torino, Italy;Dermatology Department, Azienda Sanitaria Friuli Occidentale, Pordenone, Italy;Fondazione I.R.C.C.S. Policlinico San Matteo, Pavia, Italy;IRCCS Ospedale Policlinico San Martino, Genova, Italy;Istituto Europeo di Oncologia - IRCCS, Milano, Italy;Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Napoli, Italy;Istituto Oncologico Veneto IOV - IRCCS, Padova, Italy;Oncology Department, Ospedale Sant’Anna di Como, Como, Italy;Plastic and Reconstructive Surgery Department, Università degli Studi di Bari Aldo Moro, Bari, Italy;

关键词: medical record systems;    cutaneous melanoma;    survival analysis;    immunotherapy;    ipilimumab;   

DOI  :  10.3389/fonc.2021.672797

来源: DOAJ

【 摘 要 】

BackgroundCutaneous melanoma (CM) is one of the most aggressive types of skin cancer. Currently, innovative approaches such as target therapies and immunotherapies have been introduced in clinical practice. Data of clinical trials and real life studies that evaluate the outcomes of these therapeutic associations are necessary to establish their clinical utility. The aim of this study is to investigate the types of oncological treatments employed in the real-life clinical management of patients with advanced CM in several Italian centers, which are part of the Clinical National Melanoma Registry (CNMR).MethodsMelanoma-specific survival and overall survival were calculated. Multivariate Cox regression models were used to estimate the hazard ratios adjusting for confounders and other prognostic factors.ResultsThe median follow-up time was 36 months (range 1.2-185.1). 787 CM were included in the analysis with completed information about therapies. All types of immunotherapy showed a significant improved survival compared with all other therapies (p=0.001). 75% was the highest reduction of death reached by anti-PD-1 (HR=0.25), globally immunotherapy was significantly associated with improved survival, either for anti-CTLA4 monotherapy or combined with anti-PD-1 (HR=0.47 and 0.26, respectively) and BRAFI+MEKI (HR=0.62).ConclusionsThe nivolumab/pembrolizumab in combination of ipilimumab and the addition of ant-MEK to the BRAFi can be considered the best therapies to improve survival in a real-world-population. The CNMR can complement clinical registries with the intent of improving cancer management and standardizing cancer treatment.

【 授权许可】

Unknown