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000299594 1001_ $$aForschner, Andrea$$b0
000299594 245__ $$aTreatment at the end of life in patients with advanced melanoma. A multicenter DeCOG study of 1067 patients from the prospective skin cancer registry ADOReg.
000299594 260__ $$aLausanne$$bFrontiers Media$$c2025
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000299594 520__ $$aAlthough systemic therapies have improved considerably over the last decade, up to 50% of patients with metastatic melanoma still die due to disease progression. Oncological treatment at the end-of-life phase is challenging. The aim of this study was to investigate the frequency and type of systemic therapy received by melanoma patients in their end-of-life phase.Patients with metastatic melanoma who had died between January 1, 2018 and October 31, 2022 were identified from the prospective multicenter skin cancer registry ADOReg. Study endpoints were percentage of patients who had been treated with systemic therapy within the last three months of life, timepoint of initiation of the last-line therapy, overall survival, treatment benefit and the incidence of treatment-related adverse events.In total, 1067 patients from 46 skin cancer centers were included. Most of the patients (63%) had received immune checkpoint inhibitors (ICI) as last-line therapy, 22% targeted therapies (TT) and 12% chemotherapy (CTX). Comparing last-line ICI and TT, patients with TT were significantly more likely to benefit from treatment and had significantly fewer and milder treatment-related AE than patients with ICI. Even though two thirds of patients had received ICI as a last-line therapy, the majority of these patients (61%) had stopped therapy within the last 30 days of life, whereas the majority of patients with TT (66%) still continued their treatment to the end of life. We found markedly fewer patients with initiation of ICI within 30 days before their death (19%) compared to a historic cohort including patients who died in 2016 or 2017 (39%).Treatment approaches near the end of life have markedly changed in skin cancer centers in Germany over recent years, with ICI prescribed less frequently in the end-of-life phase. In contrast, TT are frequently administered, even within the last 30 days of life. It should also be considered that discontinuation of TT can result in rapid tumor progression. Due to the oral administration and a low rate of severe toxicity, TT appear to be a suitable treatment option, even in the end-of-life situation of melanoma patients.
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000299594 650_7 $$2Other$$aBRAF and MEK inhibitors
000299594 650_7 $$2Other$$aend of life
000299594 650_7 $$2Other$$aimmune checkpoint inhibitors
000299594 650_7 $$2Other$$aipilimumab
000299594 650_7 $$2Other$$amelanoma
000299594 650_7 $$2Other$$anivolumab
000299594 650_7 $$2NLM Chemicals$$aImmune Checkpoint Inhibitors
000299594 650_2 $$2MeSH$$aHumans
000299594 650_2 $$2MeSH$$aMelanoma: drug therapy
000299594 650_2 $$2MeSH$$aMelanoma: mortality
000299594 650_2 $$2MeSH$$aMelanoma: therapy
000299594 650_2 $$2MeSH$$aMale
000299594 650_2 $$2MeSH$$aFemale
000299594 650_2 $$2MeSH$$aRegistries
000299594 650_2 $$2MeSH$$aSkin Neoplasms: drug therapy
000299594 650_2 $$2MeSH$$aSkin Neoplasms: mortality
000299594 650_2 $$2MeSH$$aAged
000299594 650_2 $$2MeSH$$aMiddle Aged
000299594 650_2 $$2MeSH$$aProspective Studies
000299594 650_2 $$2MeSH$$aAged, 80 and over
000299594 650_2 $$2MeSH$$aTerminal Care: methods
000299594 650_2 $$2MeSH$$aImmune Checkpoint Inhibitors: therapeutic use
000299594 650_2 $$2MeSH$$aImmune Checkpoint Inhibitors: adverse effects
000299594 650_2 $$2MeSH$$aAdult
000299594 650_2 $$2MeSH$$aTreatment Outcome
000299594 7001_ $$aKähler, Katharina C$$b1
000299594 7001_ $$aGschnell, Martin$$b2
000299594 7001_ $$aLangan, Ewan A$$b3
000299594 7001_ $$aWeishaupt, Carsten$$b4
000299594 7001_ $$aMeiss, Frank$$b5
000299594 7001_ $$aThoms, Kai-Martin$$b6
000299594 7001_ $$aWahl, Renate U$$b7
000299594 7001_ $$aGöppner, Daniela$$b8
000299594 7001_ $$aGarzarolli, Marlene$$b9
000299594 7001_ $$aSachse, Michael$$b10
000299594 7001_ $$aSchlaak, Max$$b11
000299594 7001_ $$aReitmajer, Markus$$b12
000299594 7001_ $$aKellner, Ivonne$$b13
000299594 7001_ $$aGesierich, Anja$$b14
000299594 7001_ $$aMohr, Peter$$b15
000299594 7001_ $$aMeier, Friedegund$$b16
000299594 7001_ $$avon Wasielewski, Imke$$b17
000299594 7001_ $$aHerbst, Rudolf$$b18
000299594 7001_ $$0P:(DE-He78)a229f7724466e7efadf4a1ace1ff8af3$$aUtikal, Jochen$$b19$$udkfz
000299594 7001_ $$aPföhler, Claudia$$b20
000299594 7001_ $$aUlrich, Jens$$b21
000299594 7001_ $$aTerheyden, Patrick$$b22
000299594 7001_ $$aKaatz, Martin$$b23
000299594 7001_ $$aHaferkamp, Sebastian$$b24
000299594 7001_ $$aLeiter, Ulrike$$b25
000299594 7001_ $$0P:(DE-HGF)0$$aUgurel, Selma$$b26
000299594 7001_ $$aWeichenthal, Michael$$b27
000299594 7001_ $$aBerking, Carola$$b28
000299594 7001_ $$aGutzmer, Ralf$$b29
000299594 7001_ $$0P:(DE-HGF)0$$aSchadendorf, Dirk$$b30
000299594 7001_ $$aNanz, Lena$$b31
000299594 7001_ $$aLoquai, Carmen$$b32
000299594 773__ $$0PERI:(DE-600)2606827-8$$a10.3389/fimmu.2025.1509886$$gVol. 16, p. 1509886$$p1509886$$tFrontiers in immunology$$v16$$x1664-3224$$y2025
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