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2. Failure to validate existing clinical prediction scale for response to PD-1 monotherapy in advanced melanoma in national cohort study

Author

van der Kooij, Monique K., Joosse, Arjen, Suijkerbuijk, Karijn P. M., Aarts, Maureen J. B., van den Berkmortel, Franchette W. P. J., Blank, Christian U., Boers-Sonderen, Marye J., van den Eertwegh, Alfonsus J. M., de Groot, Jan Willem B., Haanen, John B. A. G., Hospers, Geke A. P., Piersma, Djura, van Rijn, Rozemarijn S., van der Veldt, Astrid A. M., Vreugdenhil, Gerard, Westgeest, Hans M., Wouters, Michel W. J. M., Dekkers, Olaf M., and Kapiteijn, Ellen

Published
2023
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3. Is a History of Optimal Staging by Sentinel Lymph Node Biopsy in the Era Prior to Adjuvant Therapy Associated with Improved Outcome Once Melanoma Patients have Progressed to Advanced Disease?

Author

Blankenstein, Stephanie A., Bonenkamp, Johannes J., Aarts, Maureen J. B., van den Berkmortel, Franchette W. P. J., Blank, Christian U., Blokx, Willeke A. M., Boers-Sonderen, Marye J., van den Eertwegh, Alfons J. M., Franken, Margreet G., de Groot, Jan Willem B., Haanen, John B. A. G., Hospers, Geke A. P., Kapiteijn, Ellen W., van Not, Olivier J., Piersma, Djura, van Rijn, Rozemarijn S., Suijkerbuijk, Karijn P. M., van der Veldt, Astrid A. M., Vreugdenhil, Gerard, Westgeest, Hans M., Wouters, Michel W. J. M., and van Akkooi, Alexander C. J.

Published
2023
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11. ASO Visual Abstract: Is a History of Optimal Staging by SLNB in the Era Prior to Adjuvant Therapy Associated with Improved Outcome Once Melanoma Patients have Progressed to Advanced Disease?

Author

Blankenstein, Stephanie A., Bonenkamp, Johannes J., Aarts, Maureen J. B., van den Berkmortel, Franchette W. P. J., Blank, Christian U., Blokx, Willeke A. M., Boers-Sonderen, Marye J., van den Eertwegh, Alfons J. M., Franken, Margreet G., de Groot, Jan Willem B., Haanen, John B. A. G., Hospers, Geke A. P., Kapiteijn, Ellen W., van Not, Olivier J., Piersma, Djura, van Rijn, Rozemarijn S., Suijkerbuijk, Karijn P. M., van der Veldt, Astrid A. M., Vreugdenhil, Gerard, Westgeest, Hans M., Wouters, Michel W. J. M., and van Akkooi, Alexander C. J.

Published
2023
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13. Adverse Events in Anti-PD-1-Treated Adjuvant and First-Line Advanced Melanoma Patients

Author

MS Medische Oncologie, Cancer, Infection & Immunity, Rauwerdink, Daan Jan Willem, Not, Olivier van, de Meza, Melissa, Doorn, Remco van, Hage, Jos van der, Eertwegh, A J M van den, Haanen, John B, Aarts, Maureen J B, Berkmortel, Franchette W P J van den, Blank, Christiaan U, Boers-Sonderen, Marye J, Groot, Jan Willem B de, Hospers, Geke A P, Piersma, Djura, van Rijn, Rozemarijn S, Stevense-den Boer, A M, Veldt, Astrid A M van der, Vreugdenhil, Gerard, Wouters, Michel W J M, Suijkerbuijk, Karijn P M, Kapiteijn, Ellen, MS Medische Oncologie, Cancer, Infection & Immunity, Rauwerdink, Daan Jan Willem, Not, Olivier van, de Meza, Melissa, Doorn, Remco van, Hage, Jos van der, Eertwegh, A J M van den, Haanen, John B, Aarts, Maureen J B, Berkmortel, Franchette W P J van den, Blank, Christiaan U, Boers-Sonderen, Marye J, Groot, Jan Willem B de, Hospers, Geke A P, Piersma, Djura, van Rijn, Rozemarijn S, Stevense-den Boer, A M, Veldt, Astrid A M van der, Vreugdenhil, Gerard, Wouters, Michel W J M, Suijkerbuijk, Karijn P M, and Kapiteijn, Ellen

Published
2024

14. Long-Term Survival in Patients With Advanced Melanoma

Author

MS Medische Oncologie, Cancer, Pathologie Pathologen staf, Infection & Immunity, van Not, Olivier J, van den Eertwegh, Alfons J M, Groningen, University, Bloem, Manja, Haanen, John B, van Rijn, Rozemarijn S, Aarts, Maureen J B, van den Berkmortel, Franchette W P J, Blank, Christian U, Boers-Sonderen, Marye J, de Groot J W B, Jan Willem, Hospers, Geke A P, Kapiteijn, Ellen, Leeneman, Brenda, D, Piersma, Stevense-den Boer, Marion, van der Veldt, Astrid A M, Vreugdenhil G, Gerard, Wouters, Michel W J M, Blokx, Willeke A M, Suijkerbuijk, Karijn P M, MS Medische Oncologie, Cancer, Pathologie Pathologen staf, Infection & Immunity, van Not, Olivier J, van den Eertwegh, Alfons J M, Groningen, University, Bloem, Manja, Haanen, John B, van Rijn, Rozemarijn S, Aarts, Maureen J B, van den Berkmortel, Franchette W P J, Blank, Christian U, Boers-Sonderen, Marye J, de Groot J W B, Jan Willem, Hospers, Geke A P, Kapiteijn, Ellen, Leeneman, Brenda, D, Piersma, Stevense-den Boer, Marion, van der Veldt, Astrid A M, Vreugdenhil G, Gerard, Wouters, Michel W J M, Blokx, Willeke A M, and Suijkerbuijk, Karijn P M

Published
2024

15. Adjuvant treatment with anti-PD-1 in acral melanoma:A nationwide study

Author

Bloem, Manja, van Not, Olivier J., Aarts, Maureen J. B., van den Berkmortel, Franchette W. P. J., Blank, Christian U., Blokx, Willeke A. M., Boers-Sonderen, Marye J., Bonenkamp, Johannes J., de Groot, Jan-Willem B., Haanen, John B., Hospers, Geke A. P., Kapiteijn, Ellen W., de Meza, Melissa M., Piersma, Djura, van Rijn, Rozemarijn S., Stevense-den Boer, Marion A. M., van Der Veldt, Astrid A. M., Vreugdenhil, Gerard, van den Eertwegh, Alfons J. M., Suijkerbuijk, Karijn P. M., Wouters, Michel W. J. M., Bloem, Manja, van Not, Olivier J., Aarts, Maureen J. B., van den Berkmortel, Franchette W. P. J., Blank, Christian U., Blokx, Willeke A. M., Boers-Sonderen, Marye J., Bonenkamp, Johannes J., de Groot, Jan-Willem B., Haanen, John B., Hospers, Geke A. P., Kapiteijn, Ellen W., de Meza, Melissa M., Piersma, Djura, van Rijn, Rozemarijn S., Stevense-den Boer, Marion A. M., van Der Veldt, Astrid A. M., Vreugdenhil, Gerard, van den Eertwegh, Alfons J. M., Suijkerbuijk, Karijn P. M., and Wouters, Michel W. J. M.

Abstract

Previous studies demonstrated limited efficacy of immune checkpoint inhibitors in unresectable acral melanoma (AM); it remains unclear how this translates to the adjuvant setting. This study investigates clinical outcomes of acral compared to cutaneous melanoma (CM) patients treated with adjuvant anti-PD-1 after complete resection. All stages III-IV AM and CM patients receiving adjuvant anti-PD-1 after complete resection between 2018 and 2022 were included from the prospective nationwide Dutch Melanoma Treatment Registry. We analyzed recurrence-free survival (RFS), distant metastasis-free survival (DMFS), and overall survival (OS). A multivariable Cox regression analysis of RFS was performed to adjust for potential confounders. We included 1958 (86 AM and 1872 CM) patients. At baseline, AM patients more frequently had KIT mutations, higher disease stages, and Eastern Cooperative Oncology Group Performance Status, and fewer BRAF and NRAS mutations. Median RFS was 14.8 months (95% confidence interval [CI]: 11.5-29.3) in AM and 37.4 months (95% CI: 34.6 to not reached) in CM (p = .002). After correcting for potential confounders, AM remained associated with a higher risk of recurrence (HRadj 1.53; 95% CI: 1.07-2.17; p = .019). Two-year DMFS tended to be worse for AM than for CM: 64.5% versus 79.7% (p = .050). Two-year OS was significantly lower in AM (71.5% vs. 84.3%; p = .027). The results of this study suggest a poorer outcome of adjuvant-treated AM compared to CM. Studies assessing the added value of adjuvant treatment in AM are needed. Future research should investigate alternative treatment strategies to improve outcomes of high-risk AM.

Published
2024

16. A prediction model for response to immune checkpoint inhibition in advanced melanoma

Author

van Duin, Isabella A. J., Verheijden, Rik J., van Diest, Paul J., Blokx, Willeke A. M., El-Sharouni, Mary-Ann, Verhoeff, Joost J. C., Leiner, Tim, van den Eertwegh, Alfonsus J. M., de Groot, Jan Willem B., van Not, Olivier J., Aarts, Maureen J. B., van den Berkmortel, Franchette W. P. J., Blank, Christian U., Haanen, John B. A. G., Hospers, Geke A. P., Piersma, Djura, van Rijn, Rozemarijn S., van Der Veldt, Astrid A. M., Vreugdenhil, Gerard, Wouters, Michel W. J. M., Stevense-den Boer, Marion A. M., Boers-Sonderen, Marye J., Kapiteijn, Ellen, Suijkerbuijk, Karijn P. M., Elias, Sjoerd G., van Duin, Isabella A. J., Verheijden, Rik J., van Diest, Paul J., Blokx, Willeke A. M., El-Sharouni, Mary-Ann, Verhoeff, Joost J. C., Leiner, Tim, van den Eertwegh, Alfonsus J. M., de Groot, Jan Willem B., van Not, Olivier J., Aarts, Maureen J. B., van den Berkmortel, Franchette W. P. J., Blank, Christian U., Haanen, John B. A. G., Hospers, Geke A. P., Piersma, Djura, van Rijn, Rozemarijn S., van Der Veldt, Astrid A. M., Vreugdenhil, Gerard, Wouters, Michel W. J. M., Stevense-den Boer, Marion A. M., Boers-Sonderen, Marye J., Kapiteijn, Ellen, Suijkerbuijk, Karijn P. M., and Elias, Sjoerd G.

Abstract

Predicting who will benefit from treatment with immune checkpoint inhibition (ICI) in patients with advanced melanoma is challenging. We developed a multivariable prediction model for response to ICI, using routinely available clinical data including primary melanoma characteristics. We used a population-based cohort of 3525 patients with advanced cutaneous melanoma treated with anti-PD-1-based therapy. Our prediction model for predicting response within 6 months after ICI initiation was internally validated with bootstrap resampling. Performance evaluation included calibration, discrimination and internal–external cross-validation. Included patients received anti-PD-1 monotherapy (n = 2366) or ipilimumab plus nivolumab (n = 1159) in any treatment line. The model included serum lactate dehydrogenase, World Health Organization performance score, type and line of ICI, disease stage and time to first distant recurrence—all at start of ICI—, and location and type of primary melanoma, the presence of satellites and/or in-transit metastases at primary diagnosis and sex. The over-optimism adjusted area under the receiver operating characteristic was 0.66 (95% CI: 0.64–0.66). The range of predicted response probabilities was 7%–81%. Based on these probabilities, patients were categorized into quartiles. Compared to the lowest response quartile, patients in the highest quartile had a significantly longer median progression-free survival (20.0 vs 2.8 months; P <.001) and median overall survival (62.0 vs 8.0 months; P <.001). Our prediction model, based on routinely available clinical variables and primary melanoma characteristics, predicts response to ICI in patients with advanced melanoma and discriminates well between treated patients with a very good and very poor prognosis.

Published
2024

17. A prediction model for response to immune checkpoint inhibition in advanced melanoma

Author

Cancer, MS Medische Oncologie, Pathologie, Pathologie Pathologen staf, Pathologie Groep Van Diest, MS Radiotherapie, Brain, Circulatory Health, MS Radiologie, Infection & Immunity, Epi Kanker Team C, JC onderzoeksprogramma Kanker, van Duin, Isabella A J, Verheijden, Rik J, van Diest, Paul J, Blokx, Willeke A M, El-Sharouni, Mary-Ann, Verhoeff, Joost J C, Leiner, Tim, van den Eertwegh, Alfonsus J M, de Groot, Jan Willem B, van Not, Olivier J, Aarts, Maureen J B, van den Berkmortel, Franchette W P J, Blank, Christian U, Haanen, John B A G, Hospers, Geke A P, Piersma, Djura, van Rijn, Rozemarijn S, van der Veldt, Astrid A M, Vreugdenhil, Gerard, Wouters, Michel W J M, Stevense-den Boer, Marion A M, Boers-Sonderen, Marye J, Kapiteijn, Ellen, Suijkerbuijk, Karijn P M, Elias, Sjoerd G, Cancer, MS Medische Oncologie, Pathologie, Pathologie Pathologen staf, Pathologie Groep Van Diest, MS Radiotherapie, Brain, Circulatory Health, MS Radiologie, Infection & Immunity, Epi Kanker Team C, JC onderzoeksprogramma Kanker, van Duin, Isabella A J, Verheijden, Rik J, van Diest, Paul J, Blokx, Willeke A M, El-Sharouni, Mary-Ann, Verhoeff, Joost J C, Leiner, Tim, van den Eertwegh, Alfonsus J M, de Groot, Jan Willem B, van Not, Olivier J, Aarts, Maureen J B, van den Berkmortel, Franchette W P J, Blank, Christian U, Haanen, John B A G, Hospers, Geke A P, Piersma, Djura, van Rijn, Rozemarijn S, van der Veldt, Astrid A M, Vreugdenhil, Gerard, Wouters, Michel W J M, Stevense-den Boer, Marion A M, Boers-Sonderen, Marye J, Kapiteijn, Ellen, Suijkerbuijk, Karijn P M, and Elias, Sjoerd G

Published
2024

18. Interferon-gamma signature as prognostic and predictive marker in macroscopic stage III melanoma

Author

Pathologie Pathologen staf, Cancer, MS Medische Oncologie, Infection & Immunity, Versluis, Judith M, Blankenstein, Stephanie A, Dimitriadis, Petros, Wilmott, James S, Elens, Robert, Blokx, Willeke A M, van Houdt, Winan, Menzies, Alexander Maxwell, Schrage, Yvonne M, Wouters, Michel W J M, Sanders, Joyce, Broeks, Annegien, Scolyer, Richard A, Suijkerbuijk, Karijn P M, Long, Georgina V, Akkooi, Alexander C J van, Blank, Christian U, Pathologie Pathologen staf, Cancer, MS Medische Oncologie, Infection & Immunity, Versluis, Judith M, Blankenstein, Stephanie A, Dimitriadis, Petros, Wilmott, James S, Elens, Robert, Blokx, Willeke A M, van Houdt, Winan, Menzies, Alexander Maxwell, Schrage, Yvonne M, Wouters, Michel W J M, Sanders, Joyce, Broeks, Annegien, Scolyer, Richard A, Suijkerbuijk, Karijn P M, Long, Georgina V, Akkooi, Alexander C J van, and Blank, Christian U

Published
2024

19. BRAF/MEK inhibitor rechallenge in advanced melanoma patients

Author

Cancer, MS Medische Oncologie, Pathologie Pathologen staf, Infection & Immunity, Van Not, Olivier J, van den Eertwegh, Alfons J M, Haanen, John B, van Rijn, Rozemarijn S, Aarts, Maureen J B, van den Berkmortel, Franchette W P J, Blank, Christian U, Boers-Sonderen, Marye J, de Groot, Jan Willem W B, Hospers, Geke AP, Kapiteijn, Ellen, Bloem, Manja, Piersma, Djura, Stevense-den Boer, Marion, Verheijden, Rik J, van der Veldt, Astrid A M, Wouters, Michel W J M, Blokx, Willeke A M, Suijkerbuijk, Karijn P M, Cancer, MS Medische Oncologie, Pathologie Pathologen staf, Infection & Immunity, Van Not, Olivier J, van den Eertwegh, Alfons J M, Haanen, John B, van Rijn, Rozemarijn S, Aarts, Maureen J B, van den Berkmortel, Franchette W P J, Blank, Christian U, Boers-Sonderen, Marye J, de Groot, Jan Willem W B, Hospers, Geke AP, Kapiteijn, Ellen, Bloem, Manja, Piersma, Djura, Stevense-den Boer, Marion, Verheijden, Rik J, van der Veldt, Astrid A M, Wouters, Michel W J M, Blokx, Willeke A M, and Suijkerbuijk, Karijn P M

Published
2024

20. Improving survival in advanced melanoma patients: a trend analysis from 2013 to 2021

Author

Cancer, MS Medische Oncologie, Pathologie Pathologen staf, Infection & Immunity, van Not, Olivier J, van den Eertwegh, Alfons J M, Haanen, John B, Blank, Christian U, Aarts, Maureen J B, van Breeschoten, Jesper, van den Berkmortel, Franchette W P J, de Groot, Jan-Willem B, Hospers, Geke A P, Ismail, Rawa K, Kapiteijn, Ellen, Bloem, Manja, De Meza, Melissa M, Piersma, Djura, van Rijn, Rozemarijn S, Stevense-den Boer, Marion A M, van der Veldt, Astrid A M, Vreugdenhil, Gerard, Boers-Sonderen, Marye J, Blokx, Willeke A M, Wouters, Michel W J M, Suijkerbuijk, Karijn P M, Cancer, MS Medische Oncologie, Pathologie Pathologen staf, Infection & Immunity, van Not, Olivier J, van den Eertwegh, Alfons J M, Haanen, John B, Blank, Christian U, Aarts, Maureen J B, van Breeschoten, Jesper, van den Berkmortel, Franchette W P J, de Groot, Jan-Willem B, Hospers, Geke A P, Ismail, Rawa K, Kapiteijn, Ellen, Bloem, Manja, De Meza, Melissa M, Piersma, Djura, van Rijn, Rozemarijn S, Stevense-den Boer, Marion A M, van der Veldt, Astrid A M, Vreugdenhil, Gerard, Boers-Sonderen, Marye J, Blokx, Willeke A M, Wouters, Michel W J M, and Suijkerbuijk, Karijn P M

Published
2024

21. Checkpoint inhibitor induced hepatitis and the relation with liver metastasis and outcome in advanced melanoma patients

Author

Biewenga, Maaike, van der Kooij, Monique K., Wouters, Michel W. J. M., Aarts, Maureen J. B., van den Berkmortel, Franchette W. P. J., de Groot, Jan Willem B., Boers-Sonderen, Marye J., Hospers, Geke A. P., Piersma, Djura, van Rijn, Rozemarijn S., Suijkerbuijk, Karijn P. M., ten Tije, Albert J., van der Veldt, Astrid A. M., Vreugdenhil, Gerard, Haanen, John B. A. G., van der Eertwegh, Alfons J. M., van Hoek, Bart, and Kapiteijn, Ellen

Published
2021
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22. First-line BRAF/MEK inhibitors versus anti-PD-1 monotherapy in BRAFV600-mutant advanced melanoma patients: a propensity-matched survival analysis

Author

van Breeschoten, Jesper, Wouters, Michel W. J. M., Hilarius, Doranne L., Haanen, John B., Blank, Christian U., Aarts, Maureen J. B., van den Berkmortel, Franchette W. P. J., de Groot, Jan-Willem B., Hospers, Geke A. P., Kapiteijn, Ellen, Piersma, Djura, van Rijn, Roos S., Suijkerbuijk, Karijn P. M., Blokx, Willeke A. M., Tije, Bert-Jan J. ten, Veldt, Astrid A. M. van der, Vreugdenhil, Art, Boers-Sonderen, Marye J., and van den Eertwegh, Alfonsus J. M.

Published
2021
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23. Adverse Events in Anti-PD-1-Treated Adjuvant and First-Line Advanced Melanoma Patients.

Author

Rauwerdink, Daan Jan Willem, Not, Olivier van, de Meza, Melissa, Doorn, Remco van, Hage, Jos van der, Eertwegh, A. J. M. van den, Haanen, John B., Aarts, Maureen J. B., Berkmortel, Franchette W. P. J. van den, Blank, Christiaan U., Boers-Sonderen, Marye J., Groot, Jan Willem B. de, Hospers, Geke A. P., Piersma, Djura, van Rijn, Rozemarijn S., Stevense-den Boer, A. M., Veldt, Astrid A. M. van der, Vreugdenhil, Gerard, Wouters, Michel W. J. M., and Suijkerbuijk, Karijn P. M.

Subjects
RISK assessment, DRUG side effects, MELANOMA, SURGERY, PATIENTS, IMMUNOTHERAPY, SCIENTIFIC observation, CANCER patients, MULTIVARIATE analysis, DESCRIPTIVE statistics, RETROSPECTIVE studies, ADJUVANT chemotherapy, IMMUNE checkpoint inhibitors, LONGITUDINAL method, ODDS ratio, RESEARCH, STATISTICS, CONFIDENCE intervals, COMORBIDITY
Abstract

Simple Summary: This nationwide cohort study evaluated the incidence and severity of immune-related adverse events (irAEs) in melanoma patients receiving adjuvant versus advanced anti-PD-1 therapy. A total of 1465 advanced melanoma patients and 908 adjuvant-treated patients were included. Patients in the adjuvant group were younger, had superior ECOG performance status, and had fewer comorbidities compared to those in the advanced group. No significant difference was observed in the incidence of grade III-IV irAEs between the two groups. However, higher ECOG status (>1) and the presence of any comorbidities were independently associated with an increased risk of irAE development across both treatment settings. Although adjuvant therapy was not linked to a heightened risk of severe irAEs compared to advanced therapy, it was more frequently discontinued due to toxicity in the adjuvant group. These findings provide critical insights for informing patient consultations regarding adjuvant anti-PD-1 treatment. Introduction: The difference in incidence and severity of anti-PD-1 therapy-related adverse events (irAEs) between adjuvant and advanced treated melanoma patients remains unclear, as no head-to-head studies have compared these groups. Methods: This multi-center cohort study analyzed melanoma patients treated with anti-PD-1 in adjuvant or advanced settings between 2015 and 2021. Comorbidities and ECOG performance status were assessed before treatment, and grade III-IV irAEs were monitored during treatment. Univariate and multivariate regression analyses were conducted to identify factors associated with irAE development. Results: A total of 1465 advanced melanoma patients and 908 resected melanoma patients received anti-PD-1 therapy. Adjuvant-treated patients were younger, with a median age of 63 years compared to 69 years in the advanced group (p < 0.01), and had a better ECOG performance status (p < 0.01). Comorbidities were seen more frequently in advanced melanoma patients than in those receiving adjuvant treatment, 76% versus 68% (p < 0.01). Grade III-IV irAEs occurred in 214 (15%) advanced treated patients and in 119 (13%) adjuvant-treated patients. Multivariate analysis showed an increased risk of severe irAE development with the presence of any comorbidity (adjusted OR 1.22, 95% CI 1.02–1.44) and ECOG status greater than 1 (adjusted OR 2.00, 95% CI 1.20–3.32). Adjuvant therapy was not associated with an increased risk of irAE development compared to advanced treatment (adjusted OR 0.95, 95% CI 0.74–1.21) after correcting for comorbidities and ECOG performance score. Anti-PD-1 therapy was halted due to toxicity (any grade irAE) more often in the adjuvant setting than in the advanced setting, 20% versus 15% (p < 0.01). Conclusions: Higher ECOG performance status and presence of any comorbidity were independently associated with an increased risk of Grade III-IV irAE in adjuvant and advanced treated melanoma patients. Patients treated in the adjuvant setting did not have an increased risk of developing severe irAEs compared to advanced melanoma patients. These findings are of clinical significance in consulting patients for adjuvant anti-PD-1 treatment. [ABSTRACT FROM AUTHOR]

Published
2024
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24. A prediction model for response to immune checkpoint inhibition in advanced melanoma

Author

van Duin, Isabella A. J., primary, Verheijden, Rik J., additional, van Diest, Paul J., additional, Blokx, Willeke A. M., additional, El‐Sharouni, Mary‐Ann, additional, Verhoeff, Joost J. C., additional, Leiner, Tim, additional, van den Eertwegh, Alfonsus J. M., additional, de Groot, Jan Willem B., additional, van Not, Olivier J., additional, Aarts, Maureen J. B., additional, van den Berkmortel, Franchette W. P. J., additional, Blank, Christian U., additional, Haanen, John B. A. G., additional, Hospers, Geke A. P., additional, Piersma, Djura, additional, van Rijn, Rozemarijn S., additional, van der Veldt, Astrid A. M., additional, Vreugdenhil, Gerard, additional, Wouters, Michel W. J. M., additional, Stevense‐den Boer, Marion A. M., additional, Boers‐Sonderen, Marye J., additional, Kapiteijn, Ellen, additional, Suijkerbuijk, Karijn P. M., additional, and Elias, Sjoerd G., additional

Published
2024
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26. BRAF/MEK inhibitor rechallenge in advanced melanoma patients

Author

Van Not, Olivier J., primary, van den Eertwegh, Alfons J. M., additional, Haanen, John B., additional, van Rijn, Rozemarijn S., additional, Aarts, Maureen J. B., additional, van den Berkmortel, Franchette W. P. J., additional, Blank, Christian U., additional, Boers‐Sonderen, Marye J., additional, de Groot, Jan Willem W. B., additional, Hospers, Geke A. P., additional, Kapiteijn, Ellen, additional, Bloem, Manja, additional, Piersma, Djura, additional, Stevense‐den Boer, Marion, additional, Verheijden, Rik J., additional, van der Veldt, Astrid A. M., additional, Wouters, Michel W. J. M., additional, Blokx, Willeke A. M., additional, and Suijkerbuijk, Karijn P. M., additional

Published
2024
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29. Real-world Outcomes of Ipilimumab Plus Nivolumab Combination Therapy in a Nation-wide Cohort of Advanced Melanoma Patients in the Netherlands

Author

van Zeijl, Michiel C T, van Breeschoten, Jesper, de Wreede, Liesbeth C, Wouters, Michel W J M, Hilarius, Doranne L, Blank, Christian U, Aarts, Maureen J B, van den Berkmortel, Franchette W P J, de Groot, Jan Willem B, Hospers, Geke A P, Kapiteijn, Ellen, Piersma, Djura, van Rijn, Rozemarijn S, Stevense-den Boer, Marion A, van der Veldt, Astrid A M, Vreugdenhil, Gerard, Boers-Sonderen, Marye J, Suijkerbuijk, Karijn P M, Haanen, John B A G, van den Eertwegh, Alfons J M, Internal medicine, Obstetrics and gynaecology, Amsterdam Reproduction & Development (AR&D), Medical oncology, AII - Cancer immunology, CCA - Cancer Treatment and quality of life, CCA - Cancer biology and immunology, Medical Oncology, and Radiology & Nuclear Medicine

Subjects
Pharmacology, Cancer Research, Ipilimumab plus nivolumab, Antineoplastic Combined Chemotherapy Protocols/adverse effects, Immunology, real world, Brain Neoplasms/drug therapy, Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18], population-based, Nivolumab/therapeutic use, POOLED ANALYSIS, All institutes and research themes of the Radboud University Medical Center, SDG 3 - Good Health and Well-being, Melanoma/pathology, SURVIVAL, Immunology and Allergy, Humans, METASTATIC MELANOMA, immunotherapy, Ipilimumab/therapeutic use, Netherlands
Abstract

Item does not contain fulltext In phase III trials, ipilimumab plus nivolumab combination therapy is highly efficacious for advanced melanoma, despite many treatment-related grades 3-4 adverse events. Here, we report real-world safety and survival outcomes of ipilimumab plus nivolumab for advanced melanoma. Patients with advanced melanoma who received first-line ipilimumab plus nivolumab between January 1, 2015 and June 30, 2021 were selected from the Dutch Melanoma Treatment Registry. We evaluated response status at 3, 6, 12, 18, and 24 months. OS and PFS were estimated with the Kaplan-Meier method. Separate analyses were performed for patients with or without brain metastases and for patients who met the inclusion criteria of the Checkmate-067 trial. In total, 709 patients received first-line ipilimumab plus nivolumab. Three hundred sixty (50.7%) patients experienced grade 3-4 adverse events, with 211 of the (58.6%) patients requiring hospital admission. The median treatment duration was 42 days (IQR = 31-139). At 24 months, disease control was achieved in 37% of patients. Median PFS since the start of treatment was 6.6 months (95% CI: 5.3-8.7), and median OS was 28.7 months (95% CI: 20.7-42.2). CheckMate-067 trial-like patients had a 4-year OS of 50% (95% CI: 43-59). Among patients with no asymptomatic or symptomatic brain metastases, the 4-year OS probabilities were 48% (95% CI: 41-55), 45% (95% CI: 35-57), and 32% (95% CI: 23-46). Ipilimumab plus nivolumab can achieve long-term survival in advanced melanoma patients in a real-world setting, including patients not represented in the CheckMate-067 trial. However, the proportion of patients with disease control in the real world is lower compared with clinical trials.

Published
2023
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31. Does size matter? Hospital volume and resource use in paediatric diabetes care.

Author

de Vries, Silvia A. G., Bak, Jessica C. G., Mul, Dick, Wouters, Michel W. J. M., Nieuwdorp, Max, Verheugt, Carianne L., and Sas, Theo C. J.

Subjects
MEDICAL care use, HOSPITAL utilization, MEDICAL quality control, MEDICAL technology, RESEARCH funding, HOSPITAL care, RETROSPECTIVE studies, DESCRIPTIVE statistics, PEDIATRICS, LONGITUDINAL method, ODDS ratio, CONFIDENCE intervals, DIABETES, MEDICAL care costs, SOCIAL classes
Abstract

Aims: Paediatric diabetes care has become increasingly specialised due to the multidisciplinary approach and technological developments. Guidelines recommend sufficient experience of treatment teams. This study evaluates associations between hospital volume and resource use and hospital expenditure in Dutch children with diabetes. Methods: Retrospective cohort study using hospital claims data of 5082 children treated across 44 Dutch hospitals (2019–2020). Hospitals were categorised into three categories; small (≥20–100 patients), medium (≥100–200 patients) and large (≥200 patients). All‐cause hospitalisations, consultations, technology and hospital expenditure were analysed and adjusted for age, sex, socio‐economic status (SES) and hospital of treatment. Results: Fewer hospitalisations were observed in large hospitals compared to small hospitals (OR 0.48; [95% CI 0.32–0.72]; p < 0.001). Median number of yearly paediatrician visits was 7 in large and 6 in small hospitals, the significance of which was attenuated in multilevel analysis (OR ≥7 consultations: 1.89; [95%CI 0.74–4.83]; p = 0.18). Technology use varies between individual hospitals, whereas pump usage and real‐time continuous glucose monitoring showed no significant differences between hospital volumes. Mean overall expenditure was highest in medium‐sized centres with €6434 per patient (IQR €2555–7955); the difference in diabetes care costs was not significant between hospital patient volumes. Conclusions: Care provision patterns vary by hospital patient volume. Large hospitals had the lowest hospitalisation rates. The use of diabetes technology was not different between hospital patient volumes. Medium‐sized hospitals showed the highest overall expenditure, but diabetes care costs were similar across hospital volumes. [ABSTRACT FROM AUTHOR]

Published
2024
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33. Using Existing Clinical Information Models for Dutch Quality Registries to Reuse Data and Follow COUMT Paradigm

Author

Schepens, Maike H. J., Trompert, Annemarie C., van Hooff, Miranda L., van der Velde, Erik, Kallewaard, Marjon, Verberk-Jonkers, Iris J. A. M., Cense, Huib A., Somford, Diederik M., Repping, Sjoerd, Tromp, Selma C., Wouters, Michel W. J. M., Center for Reproductive Medicine, APH - Personalized Medicine, and ARD - Amsterdam Reproduction and Development

Subjects
Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10], All institutes and research themes of the Radboud University Medical Center, Health Information Management, national quality registries, secondary use, data reuse, interoperability, Health Informatics, electronic health record, administrative burden, clinical information models, FAIR, Computer Science Applications
Abstract

Background Reuse of health care data for various purposes, such as the care process, for quality measurement, research, and finance, will become increasingly important in the future; therefore, “Collect Once Use Many Times” (COUMT). Clinical information models (CIMs) can be used for content standardization. Data collection for national quality registries (NQRs) often requires manual data entry or batch processing. Preferably, NQRs collect required data by extracting data recorded during the health care process and stored in the electronic health record. Objectives The first objective of this study was to analyze the level of coverage of data elements in NQRs with developed Dutch CIMs (DCIMs). The second objective was to analyze the most predominant DCIMs, both in terms of the coverage of data elements as well as in their prevalence across existing NQRs. Methods For the first objective, a mapping method was used which consisted of six steps, ranging from a description of the clinical pathway to a detailed mapping of data elements. For the second objective, the total number of data elements that matched with a specific DCIM was counted and divided by the total number of evaluated data elements. Results An average of 83.0% (standard deviation: 11.8%) of data elements in studied NQRs could be mapped to existing DCIMs . In total, 5 out of 100 DCIMs were needed to map 48.6% of the data elements. Conclusion This study substantiates the potential of using existing DCIMs for data collection in Dutch NQRs and gives direction to further implementation of DCIMs. The developed method is applicable to other domains. For NQRs, implementation should start with the five DCIMs that are most prevalently used in the NQRs. Furthermore, a national agreement on the leading principle of COUMT for the use and implementation for DCIMs and (inter)national code lists is needed.

Published
2023
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34. Correction: First-line BRAF/MEK inhibitors versus anti-PD-1 monotherapy in BRAFV600-mutant advanced melanoma patients: a propensity-matched survival analysis

Author

van Breeschoten, Jesper, Wouters, Michel W. J. M., Hilarius, Doranne L., Haanen, John B., Blank, Christian U., Aarts, Maureen J. B., van den Berkmortel, Franchette W. P. J., de Groot, Jan-Willem B., Hospers, Geke A. P., Kapiteijn, Ellen, Piersma, Djura, van Rijn, Roos S., Suijkerbuijk, Karijn P. M., Blokx, Willeke A. M., Tije, Bert-Jan J. ten, Veldt, Astrid A. M. van der, Vreugdenhil, Art, Boers-Sonderen, Marye J., and van den Eertwegh, Alfonsus J. M.

Published
2022
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42. A Survival Tree of Advanced Melanoma Patients with Brain Metastases Treated with Immune Checkpoint Inhibitors

Author

van Not, Olivier J., primary, Wind, Thijs T., additional, Ismail, Rawa K., additional, Bhattacharya, Arkajyoti, additional, Jalving, Mathilde, additional, Blank, Christian U., additional, Aarts, Maureen J. B., additional, van den Berkmortel, Franchette W. P. J., additional, Boers-Sonderen, Marye J., additional, van den Eertwegh, Alfonsus J. M., additional, de Groot, Jan Willem B., additional, Haanen, John B., additional, Kapiteijn, Ellen, additional, Bloem, Manja, additional, Piersma, Djura, additional, van Rijn, Rozemarijn S., additional, Stevense-den Boer, Marion, additional, van der Veldt, Astrid A. M., additional, Vreugdenhil, Gerard, additional, Wouters, Michel W. J. M., additional, Blokx, Willeke A. M., additional, Suijkerbuijk, Karijn P. M., additional, Fehrmann, Rudolf S. N., additional, and Hospers, Geke A. P., additional

Published
2023
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43. Use of hospital care among Dutch diabetes patients

Author

de Vries, Silvia A. G., primary, Bak, Jessica C. G., additional, Stangenberger, Vincent A., additional, Wouters, Michel W. J. M., additional, Nieuwdorp, Max, additional, Sas, Theo C. J., additional, and Verheugt, Carianne L., additional

Published
2023
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44. Adjuvant treatment of in‐transit melanoma: Narrowing the knowledge gap left by clinical trials

Author

de Meza, Melissa M., primary, Blokx, Willeke A. M., additional, Bonenkamp, Han J., additional, Blank, Cristian U., additional, Aarts, Maureen J. B., additional, van den Berkmortel, Franchette W. P. J., additional, Boers‐Sonderen, Marye J., additional, de Groot, Jan Willem B., additional, Haanen, John B., additional, Hospers, Geke A. P., additional, Kapiteijn, Ellen W., additional, van Not, Olivier J., additional, Piersma, Djura, additional, van Rijn, Rozemarijn S., additional, Stevense‐Den Boer, Marion A., additional, van der Veldt, Astrid A. M., additional, Vreugdenhil, Gerard, additional, van den Eertwegh, Alfons J. M., additional, Suijkerbuijk, Karijn P. M., additional, and Wouters, Michel W. J. M., additional

Published
2023
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45. Time interval from primary melanoma to first distant recurrence in relation to patient outcomes in advanced melanoma

Author

van Duin, Isabella A. J., primary, Elias, Sjoerd G., additional, van den Eertwegh, Alfonsus J. M., additional, de Groot, Jan Willem B., additional, Blokx, Willeke A. M., additional, van Diest, Paul J., additional, Leiner, Tim, additional, Verhoeff, Joost J. C., additional, Verheijden, Rik J., additional, van Not, Olivier J., additional, Aarts, Maureen J. B., additional, van den Berkmortel, Franchette W. P. J., additional, Blank, Christian U., additional, Haanen, John B. A. G., additional, Hospers, Geke A. P., additional, Kamphuis, Anna M., additional, Piersma, Djura, additional, van Rijn, Rozemarijn S., additional, van der Veldt, Astrid A. M., additional, Vreugdenhil, Gerard, additional, Wouters, Michel W. J. M., additional, Stevense‐den Boer, Marion A. M., additional, Boers‐Sonderen, Marye J., additional, Kapiteijn, Ellen, additional, and Suijkerbuijk, Karijn P. M., additional

Published
2023
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46. Case-mix adjustment to compare hospital performances regarding complications after cytoreductive surgery for ovarian cancer: a nationwide population-based study

Author

Algera, Marc Daniël, Baldewpersad Tewarie, Nishita M S, Driel, Willemien J van, van Ham, Maaike A P C, Slangen, Brigitte F M, Kruitwagen, Roy F P M, Wouters, Michel W J M, Participants of the Dutch Gynecological Oncology Audit Collaborator Group, Algera, Marc Daniël, Baldewpersad Tewarie, Nishita M S, Driel, Willemien J van, van Ham, Maaike A P C, Slangen, Brigitte F M, Kruitwagen, Roy F P M, Wouters, Michel W J M, and Participants of the Dutch Gynecological Oncology Audit Collaborator Group

Abstract

OBJECTIVE: Complication rates after cytoreductive surgery are important quality indicators for hospitals that treat patients with advanced-stage ovarian cancer. Case-mix factors are patient and tumor characteristics that may influence hospital outcomes such as the complication rates. Currently, no case-mix adjustment model exists for complications after cytoreductive surgery; therefore, it is unclear whether hospitals are being compared correctly. This study aims to develop the first case-mix adjustment model for complications after surgery for advanced-stage ovarian cancer, enabling an accurate comparison between hospitals.METHODS: This population-based study included all patients undergoing cytoreductive surgery for advanced-stage ovarian cancer registered in the Netherlands in 2017-2019. Case-mix variables were identified and assessed using logistic regressions. The primary outcome was the composite outcome measure 'complicated course'. Patients had a complicated course when at least one of the following criteria were met: (1) any complication combined with a prolonged length of hospital stay; (2) complication requiring reintervention; (3) any complication with a prolonged length of stay in the intensive care unit; or (4) 30-day mortality or in-hospital mortality during admission following surgery. Inter-hospital variation was analyzed using univariable and multivariable logistic regressions and visualized using funnel plots.RESULTS: A total of 1822 patients were included, of which 10.7% (n=195) had a complicated course. Comorbidity and tumor stage had a significant impact on complicated course rates in multivariable logistic regression. Inter-hospital variation was not significant for case-mix factors. Complicated course rates ranged between 2.2% and 29.1%, and case-mix adjusted observed/expected ratios ranged from 0.20 to 2.67 between hospitals. Three hospitals performed outside the confidence intervals for complicated course rates. These hospi

Published
2023

47. Time interval from primary melanoma to first distant recurrence in relation to patient outcomes in advanced melanoma

Author

van Duin, Isabella A J, Elias, Sjoerd G, van den Eertwegh, Alfonsus J M, de Groot, Jan Willem B, Blokx, Willeke A M, van Diest, Paul J, Leiner, Tim, Verhoeff, Joost J C, Verheijden, Rik J, van Not, Olivier J, Aarts, Maureen J B, van den Berkmortel, Franchette W P J, Blank, Christian U, Haanen, John B A G, Hospers, Geke A P, Kamphuis, Anna M, Piersma, Djura, van Rijn, Rozemarijn S, van der Veldt, Astrid A M, Vreugdenhil, Gerard, Wouters, Michel W J M, Stevense-den Boer, Marion A M, Boers-Sonderen, Marye J, Kapiteijn, Ellen, Suijkerbuijk, Karijn P M, van Duin, Isabella A J, Elias, Sjoerd G, van den Eertwegh, Alfonsus J M, de Groot, Jan Willem B, Blokx, Willeke A M, van Diest, Paul J, Leiner, Tim, Verhoeff, Joost J C, Verheijden, Rik J, van Not, Olivier J, Aarts, Maureen J B, van den Berkmortel, Franchette W P J, Blank, Christian U, Haanen, John B A G, Hospers, Geke A P, Kamphuis, Anna M, Piersma, Djura, van Rijn, Rozemarijn S, van der Veldt, Astrid A M, Vreugdenhil, Gerard, Wouters, Michel W J M, Stevense-den Boer, Marion A M, Boers-Sonderen, Marye J, Kapiteijn, Ellen, and Suijkerbuijk, Karijn P M

Abstract

Since the introduction of BRAF(/MEK) inhibition and immune checkpoint inhibition (ICI), the prognosis of advanced melanoma has greatly improved. Melanoma is known for its remarkably long time to first distant recurrence (TFDR), which can be decades in some patients and is partly attributed to immune-surveillance. We investigated the relationship between TFDR and patient outcomes after systemic treatment for advanced melanoma. We selected patients undergoing first-line systemic therapy for advanced melanoma from the nationwide Dutch Melanoma Treatment Registry. The association between TFDR and progression-free survival (PFS) and overall survival (OS) was assessed by Cox proportional hazard regression models. The TFDR was modeled categorically, linearly, and flexibly using restricted cubic splines. Patients received anti-PD-1-based treatment (n = 1844) or BRAF(/MEK) inhibition (n = 1618). For ICI-treated patients with a TFDR <2 years, median OS was 25.0 months, compared to 37.3 months for a TFDR >5 years (P = .014). Patients treated with BRAF(/MEK) inhibition with a longer TFDR also had a significantly longer median OS (8.6 months for TFDR <2 years compared to 11.1 months for >5 years, P = .004). The hazard of dying rapidly decreased with increasing TFDR until approximately 5 years (HR 0.87), after which the hazard of dying further decreased with increasing TFDR, but less strongly (HR 0.82 for a TFDR of 10 years and HR 0.79 for a TFDR of 15 years). Results were similar when stratifying for type of treatment. Advanced melanoma patients with longer TFDR have a prolonged PFS and OS, irrespective of being treated with first-line ICI or targeted therapy.

Published
2023

48. Adjuvant treatment of in-transit melanoma:Narrowing the knowledge gap left by clinical trials

Author

de Meza, Melissa M, Blokx, Willeke A M, Bonenkamp, Han J, Blank, Cristian U, Aarts, Maureen J B, van den Berkmortel, Franchette W P J, Boers-Sonderen, Marye J, de Groot, Jan Willem B, Haanen, John B, Hospers, Geke A P, Kapiteijn, Ellen W, van Not, Olivier J, Piersma, Djura, van Rijn, Rozemarijn S, Stevense-Den Boer, Marion A, van der Veldt, Astrid A M, Vreugdenhil, Gerard, van den Eertwegh, Alfons J M, Suijkerbuijk, Karijn P M, Wouters, Michel W J M, de Meza, Melissa M, Blokx, Willeke A M, Bonenkamp, Han J, Blank, Cristian U, Aarts, Maureen J B, van den Berkmortel, Franchette W P J, Boers-Sonderen, Marye J, de Groot, Jan Willem B, Haanen, John B, Hospers, Geke A P, Kapiteijn, Ellen W, van Not, Olivier J, Piersma, Djura, van Rijn, Rozemarijn S, Stevense-Den Boer, Marion A, van der Veldt, Astrid A M, Vreugdenhil, Gerard, van den Eertwegh, Alfons J M, Suijkerbuijk, Karijn P M, and Wouters, Michel W J M

Abstract

Few clinical trials address efficacy of adjuvant systemic treatment in patients with in-transit melanoma (ITM). This study describes adjuvant systemic therapy of ITM patients beyond clinical trials. In this study, we included stage III adjuvant-treated melanoma patients registered in the nationwide Dutch Melanoma Treatment Registry between July 2018 and December 2020. Patients were divided into three groups: nodal disease only, ITM only and ITM and nodal disease. Recurrence patterns, recurrence-free survival (RFS) and overall survival (OS) at 12-months were analyzed. In our study population of 1037 patients, 66.8% had nodal disease only, 16.7% had ITM only and 16.2% had ITM with nodal disease. RFS at 12-months was comparable in the nodal only and ITM only group (72.2% vs70.1%, P = .97) but lower in ITM and nodal disease patients (57.8%; P = .01, P < .01). Locoregional metastases occurred as first recurrence in 38.9% nodal disease only, 71.9% of ITM-only and 44.0% of ITM and nodal disease patients. Distant recurrences occurred in 42.3%, 18.8% and 36.0%, respectively (P = .02). 12-months OS was not significantly different for nodal disease only patients compared with ITM-only (94.4% vs 97.6%, P = .06) but was significantly higher for ITM-only compared with ITM and nodal disease patients (97.6% vs 91.0%, P < .01). In conclusion, we showed that in the adjuvant setting, RFS rates in ITM-only patients are similar to non-ITM, though better than in ITM and nodal disease patients. Adjuvant-treated ITM-only patients less often experience distant recurrences and have a superior OS compared with ITM and nodal disease patients.

Published
2023

49. Adjuvant BRAF-MEK Inhibitors versus Anti PD-1 Therapy in Stage III Melanoma:A Propensity-Matched Outcome Analysis

Author

De Meza, Melissa M, Blokx, Willeke A M, Bonenkamp, Johannes J, Blank, Christian U, Aarts, Maureen J B, van den Berkmortel, Franchette W P J, Boers-Sonderen, Marye J, De Groot, Jan Willem B, Haanen, John B A G, Hospers, Geke A P, Kapiteijn, Ellen, Van Not, Olivier J, Piersma, Djura, Van Rijn, Rozemarijn S, Stevense-den Boer, Marion, Van der Veldt, Astrid A M, Vreugdenhil, Gerard, Van den Eertwegh, Alfonsus J M, Suijkerbuijk, Karijn P M, Wouters, Michel W J M, De Meza, Melissa M, Blokx, Willeke A M, Bonenkamp, Johannes J, Blank, Christian U, Aarts, Maureen J B, van den Berkmortel, Franchette W P J, Boers-Sonderen, Marye J, De Groot, Jan Willem B, Haanen, John B A G, Hospers, Geke A P, Kapiteijn, Ellen, Van Not, Olivier J, Piersma, Djura, Van Rijn, Rozemarijn S, Stevense-den Boer, Marion, Van der Veldt, Astrid A M, Vreugdenhil, Gerard, Van den Eertwegh, Alfonsus J M, Suijkerbuijk, Karijn P M, and Wouters, Michel W J M

Abstract

Adjuvant BRAF/MEK- and anti-PD-1 inhibition have significantly improved recurrence-free survival (RFS) compared to placebo in resected stage III BRAF-mutant melanoma. However, data beyond the clinical trial setting are limited. This study describes the toxicity and survival of patients treated with adjuvant BRAF/MEK inhibitors and compares outcomes to adjuvant anti-PD-1. For this study, stage III BRAF V600 mutant cutaneous melanoma patients treated with adjuvant BRAF/MEK-inhibition or anti-PD-1 were identified from the Dutch Melanoma Treatment Registry. BRAF/MEK- and anti-PD-1-treated patients were matched based on propensity scores, and RFS at 12 and 18 months were estimated. Between 1 July 2018 and 31 December 2021, 717 patients were identified. Of these, 114 patients with complete records were treated with BRAF/MEK therapy and 532 with anti-PD-1. Comorbidities (p = 0.04) and geographical region (p < 0.01) were associated with treatment choice. In 45.6% of BRAF/MEK-treated patients, treatment was prematurely discontinued. Grade ≥ 3 toxicity occurred in 11.5% of patients and was the most common cause of early discontinuation (71.1%). At 12 and 18 months, RFS in BRAF/MEK-treated patients was 85% and 70%, compared to 68% and 68% in matched anti-PD-1-treated patients (p = 0.03). In conclusion, comorbidities and geographical region determine the choice of adjuvant treatment in patients with resected stage III BRAF-mutant melanoma. With the currently limited follow-up, BRAF/MEK-treated patients have better RFS at 12 months than matched anti-PD-1-treated patients, but this difference is no longer observed at 18 months. Therefore, longer follow-up data are necessary to estimate long-term effectiveness.

Published
2023

50. Response to letter Re: Response to checkpoint inhibition and targeted therapy in melanoma patients with concurrent haematological malignancies

Author

Cancer, MS Medische Oncologie, Pathologie Pathologen staf, Infection & Immunity, van Not, Olivier J, Blokx, Willeke A M, Wouters, Michel W J M, Suijkerbuijk, Karijn P M, Cancer, MS Medische Oncologie, Pathologie Pathologen staf, Infection & Immunity, van Not, Olivier J, Blokx, Willeke A M, Wouters, Michel W J M, and Suijkerbuijk, Karijn P M

Published
2023

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