Evolving patterns in systemic treatment utilization and survival among older patients with advanced cutaneous melanoma

Abstract Introduction In the last decade, melanoma treatment has improved significantly. However, data on population‐level treatment utilization and survival trends among older patients is limited. This study aimed to analyze trends in systemic anticancer therapy (Rx), including the uptake of immune checkpoint inhibitors (ICIs), in conjunction with trends in cause‐specific survival among older patients (66+) diagnosed with advanced melanoma (2008–2019). Methods We used the Surveillance, Epidemiology, and End Results (SEER)‐Medicare Condensed Resource to assess any Rx utilization among patients first diagnosed with advanced melanoma in 2008–2010, 2011–2014, and 2015–2019, stratified by stage, and type of first‐line Rx among patients receiving Rx. The SEER dataset was used to evaluate trends in cause‐specific survival by year of diagnosis. Results Rx utilization (any type) almost doubled, from 28.6% (2008–2010) to 55.4% (2015–2019) for stage 3 melanoma, and from 35.5% to 68.0% for stage 4 melanoma. In 2008–2010, the standard first‐line treatment was cytokines/cytotoxic chemotherapy/other. By 2015–2019, only 5.1% (stage 3) and