AUTHOR=Crispo Anna , Corradin Maria Teresa , Giulioni Erika , Vecchiato Antonella , Del Fiore Paolo , Queirolo Paola , Spagnolo Francesco , Vanella Vito , Caracò Corrado , Tosti Giulio , Pennacchioli Elisabetta , Giudice Giuseppe , Nacchiero Eleonora , Quaglino Pietro , Ribero Simone , Giordano Monica , Marussi Desire , Barruscotti Stefania , Guida Michele , De Giorgi Vincenzo , Occelli Marcella , Grosso Federica , Cairo Giuseppe , Gatti Alessandro , Massa Daniela , Atzori Laura , Calvani Nicola , Fabrizio Tommaso , Mastrangelo Giuseppe , Toffolutti Federica , Celentano Egidio , Budroni Mario , Gandini Sara , Rossi Carlo Riccardo , Testori Alessandro , Palmieri Giuseppe , Ascierto Paolo A. , the Clinical National Melanoma Registry Study Group at the Italian Melanoma Intergroup , Cespa Maddalena , Forcignanò Rosachiara , Moise Gianmichele , Fargnoli Maria Concetta , Ferreli Caterina , Grimaldi Maria , Zannetti Guido , Cinieri Saverio , Trevisan Giusto , Stanganelli Ignazio , Moretti Giovanna , Bruder Francesca , Bianchi Luca , Fierro Maria Teresa , Mascheroni Luigi , Asero Salvatore , Catricalà Caterina , Staibano Stefania , Rinaldi Gaetana , Pellicano Riccardo , Milesi Laura , Visini Marilena , Di Filippo Franco , Zichichi Leonardo , Pizzichetta Maria Antonietta , Iacono Carmelo , Guidoboni Massimo , Sanna Giovanni , Maio Michele , Lospalluti Lucia , Barbati Rosanna , Vita Leonardi , Pollio Annamaria , Riberti Carlo TITLE=Real Life Clinical Management and Survival in Advanced Cutaneous Melanoma: The Italian Clinical National Melanoma Registry Experience JOURNAL=Frontiers in Oncology VOLUME=11 YEAR=2021 URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2021.672797 DOI=10.3389/fonc.2021.672797 ISSN=2234-943X ABSTRACT=Background

Cutaneous melanoma (CM) is one of the most aggressive types of skin cancer. Currently, innovative approaches such as target therapies and immunotherapies have been introduced in clinical practice. Data of clinical trials and real life studies that evaluate the outcomes of these therapeutic associations are necessary to establish their clinical utility. The aim of this study is to investigate the types of oncological treatments employed in the real-life clinical management of patients with advanced CM in several Italian centers, which are part of the Clinical National Melanoma Registry (CNMR).

Methods

Melanoma-specific survival and overall survival were calculated. Multivariate Cox regression models were used to estimate the hazard ratios adjusting for confounders and other prognostic factors.

Results

The median follow-up time was 36 months (range 1.2-185.1). 787 CM were included in the analysis with completed information about therapies. All types of immunotherapy showed a significant improved survival compared with all other therapies (p=0.001). 75% was the highest reduction of death reached by anti-PD-1 (HR=0.25), globally immunotherapy was significantly associated with improved survival, either for anti-CTLA4 monotherapy or combined with anti-PD-1 (HR=0.47 and 0.26, respectively) and BRAFI+MEKI (HR=0.62).

Conclusions

The nivolumab/pembrolizumab in combination of ipilimumab and the addition of ant-MEK to the BRAFi can be considered the best therapies to improve survival in a real-world-population. The CNMR can complement clinical registries with the intent of improving cancer management and standardizing cancer treatment.