Treatment patterns of malignant melanoma in the United States from 2011 to 2016: a retrospective cohort study

Abstract

Background: Since 2011, the approval of several new agents has improved treatment options for malignant melanoma. We describe treatment patterns for malignant melanoma in the United States from the MarketScan database from 2011 to 2016. Methods: Treatments used for patients aged >18 years diagnosed with malignant melanoma after January 1, 2011 and enrolled in the Truven MarketScan database were analyzed. Patient data were collected for the 12-month period from the date of the first melanoma diagnosis to either death, the pre-specified study end date (August 31, 2016), or date of termination of health insurance. Treatment patterns from 2011–2013 and 2014–2016 were analyzed according to agent, year of drug administration, and line of therapy. Results: From 2011 to 2016, use of cytokines (63.8%; 13.3%) and chemotherapy (19.6%; 12.9%) decreased, and use of checkpoint inhibitors increased (2.0%; 49.9%). Checkpoint inhibitor use also increased across all lines of therapy from 2011–2013 and 2014–2016. Use of BRAF/MEK inhibitors remained relatively stable from 2011 to 2016 (6.5%–12.5%); however, the use of vemurafenib monotherapy decreased (6.5%; 0.8%), and treatment with combination regimens increased (0%; 10.9%) from 2011 to 2016. BRAF/MEK inhibitor use only increased in the first line setting from 2011–2013 (9.7%) to 2014–2016 (11.2%). Conclusion: With the approval of immune checkpoint inhibitors, BRAF/MEK inhibitors, and targeted therapies, the therapeutic landscape for the treatment of metastatic melanoma has shifted dramatically away from cytokines and chemotherapy. Treatment patterns will likely continue to evolve as scientific advances are made.