1. Clinical outcome of patients with metastatic melanoma of unknown primary in the era of novel therapy
- Author
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D. Verver, Astrid A M van der Veldt, Jan Willem B. de Groot, Maureen J.B. Aarts, Alfonsus J. M. van den Eertwegh, John B. A. G. Haanen, Karijn P M Suijkerbuijk, Franchette W P J van den Berkmortel, Gerard Vreugdenhil, Djura Piersma, Marye J Boers-Sonderen, Ellen Kapiteijn, Albert J. ten Tije, Dirk J. Grünhagen, Cornelis Verhoef, Geke A. P. Hospers, Rozemarijn S. van Rijn, Alexander C.J. van Akkooi, RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy, MUMC+: MA Medische Oncologie (9), Guided Treatment in Optimal Selected Cancer Patients (GUTS), Internal medicine, AII - Cancer immunology, CCA - Cancer Treatment and quality of life, Surgery, Medical Oncology, and Radiology & Nuclear Medicine
- Subjects
Oncology ,Male ,Cancer Research ,medicine.medical_specialty ,Skin Neoplasms ,medicine.medical_treatment ,Immunology ,Antineoplastic Agents ,Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18] ,Targeted therapy ,03 medical and health sciences ,Known primary ,0302 clinical medicine ,Interquartile range ,Internal medicine ,Novel therapy ,Immunology and Allergy ,Medicine ,Humans ,Stage IIIC ,030212 general & internal medicine ,Molecular Targeted Therapy ,Melanoma ,Immune Checkpoint Inhibitors ,Aged ,Performance status ,business.industry ,Proportional hazards model ,Unknown primary ,Hazard ratio ,Middle Aged ,medicine.disease ,Confidence interval ,030220 oncology & carcinogenesis ,Neoplasms, Unknown Primary ,Original Article ,Female ,business - Abstract
Melanoma of unknown primary (MUP) is considered different from melanoma of known primary (MKP), and it is unclear whether these patients benefit equally from novel therapies. In the current study, characteristics and overall survival (OS) of patients with advanced and metastatic MUP and MKP were compared in the era of novel therapy. Patients were selected from the prospective nation-wide Dutch Melanoma Treatment Registry (DMTR). The following criteria were applied: diagnosis of stage IIIc unresectable or IV cutaneous MKP (cMKP) or MUP between July 2012 and July 2017 and treatment with immune checkpoint inhibition and/or targeted therapy. OS was estimated using the Kaplan–Meier method. The stratified multivariable Cox regression model was used for adjusted analysis. A total of 2706 patients were eligible including 2321 (85.8%) patients with cMKP and 385 (14.2%) with MUP. In comparative analysis, MUP patients more often presented with advanced and metastatic disease at primary diagnosis with poorer performance status, higher LDH, and central nervous system metastases. In crude analysis, median OS of cMKP or MUP patients was 12 months (interquartile range [IQR] 5 – 44) and 14 months (IQR 5 – not reached), respectively (P = 0.278). In adjusted analysis, OS in MUP patients was superior (hazard rate 0.70, 95% confidence interval 0.58–0.85; P
- Published
- 2021