Treatment patterns in patients with metastatic melanoma: a retrospective analysis.
Treatment patterns in patients with metastatic melanoma: a retrospective analysis.
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DOI：
10.1155/2014/371326
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发表时间：
2014
影响因子：
1.1
通讯作者：
Barber BL
中科院分区：
文献类型：
--
作者：
Zhao Z;Wang S;Barber BL
客观的。描述现实世界中美国转移性黑色素瘤 (MM) 患者的治疗模式和影响治疗的因素。方法。这是一项基于索赔的回顾性研究，对象是从 MarketScan 数据库中确定的 2005 年至 2010 年间诊断的 MM 患者。结果。在 2546 名 MM 患者中，66.8% 接受了手术，44.7% 接受了放射治疗，38.7% 接受了全身治疗，17.7% 接受了所有治疗。患有肺、脑、肝或骨转移的患者接受手术的可能性较小（所有 P < 0.0001）；患有肺转移（P = 0.04）、脑转移（P < 0.001）或肝转移（P = 0.03）的患者更有可能接受全身治疗；患有脑转移（P < 0.0001）或骨转移（P < 0.0001）的患者更有可能接受放射治疗。肿瘤科医生更有可能推荐全身治疗（P < 0.0001）或放射治疗（P < 0.0001），而皮肤科医生更有可能推荐手术（P = 0.002）。单一疗法是主要的全身疗法（82.4% 的患者为一线疗法）。结论。只有 39% 的 MM 患者接受了全身治疗，这可能反映了 MM 传统全身治疗的疗效和安全性局限性。在接受全身治疗的患者中，单一疗法是最常见的方法。转移部位和医生专业影响治疗模式。这项研究可作为新药批准后未来治疗模式研究的基线。
Objective. To describe treatment patterns and factors influencing treatment in a real-world setting of US patients with metastatic melanoma (MM). Methods. This was a retrospective claims-based study among patients with MM diagnosed between 2005 and 2010 identified from MarketScan databases. Results. Of 2546 MM patients, 66.8% received surgery, 44.7% received radiation, 38.7% received systemic therapies, and 17.7% received all modalities. Patients with lung, brain, liver, or bone metastases were less likely to undergo surgery (all P < 0.0001); patients with lung (P = 0.04), brain (P < 0.001), or liver metastases (P = 0.03) were more likely to receive systemic therapies; patients with brain (P < 0.0001) or bone metastases (P < 0.0001) were more likely to receive radiation therapy. Oncologists were more likely to recommend systemic therapy (P < 0.0001) or radiation (P < 0.0001), while dermatologists were more likely to recommend surgery (P = 0.002). Monotherapy was the dominant systemic therapy (82.4% patients as first-line). Conclusions. Only 39% of MM patients received systemic therapies, perhaps reflecting efficacy and safety limitations of conventional systemic therapies for MM. Among those receiving systemic therapy, monotherapy was the most common approach. Sites of metastases and physician speciality influenced treatment patterns. This study serves as a baseline against which future treatment pattern studies, following approval of new agents, can be compared.