Home > Publications database > Treatment at the end of life in patients with advanced melanoma. A multicenter DeCOG study of 1067 patients from the prospective skin cancer registry ADOReg. > print

001     299594
005     20250316015805.0
024 7 _ |a 10.3389/fimmu.2025.1509886
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037 _ _ |a DKFZ-2025-00535
041 _ _ |a English
082 _ _ |a 610
100 1 _ |a Forschner, Andrea
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245 _ _ |a Treatment at the end of life in patients with advanced melanoma. A multicenter DeCOG study of 1067 patients from the prospective skin cancer registry ADOReg.
260 _ _ |a Lausanne
|c 2025
|b Frontiers Media
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520 _ _ |a Although 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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650 _ 7 |a BRAF and MEK inhibitors
|2 Other
650 _ 7 |a end of life
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650 _ 7 |a immune checkpoint inhibitors
|2 Other
650 _ 7 |a ipilimumab
|2 Other
650 _ 7 |a melanoma
|2 Other
650 _ 7 |a nivolumab
|2 Other
650 _ 7 |a Immune Checkpoint Inhibitors
|2 NLM Chemicals
650 _ 2 |a Humans
|2 MeSH
650 _ 2 |a Melanoma: drug therapy
|2 MeSH
650 _ 2 |a Melanoma: mortality
|2 MeSH
650 _ 2 |a Melanoma: therapy
|2 MeSH
650 _ 2 |a Male
|2 MeSH
650 _ 2 |a Female
|2 MeSH
650 _ 2 |a Registries
|2 MeSH
650 _ 2 |a Skin Neoplasms: drug therapy
|2 MeSH
650 _ 2 |a Skin Neoplasms: mortality
|2 MeSH
650 _ 2 |a Aged
|2 MeSH
650 _ 2 |a Middle Aged
|2 MeSH
650 _ 2 |a Prospective Studies
|2 MeSH
650 _ 2 |a Aged, 80 and over
|2 MeSH
650 _ 2 |a Terminal Care: methods
|2 MeSH
650 _ 2 |a Immune Checkpoint Inhibitors: therapeutic use
|2 MeSH
650 _ 2 |a Immune Checkpoint Inhibitors: adverse effects
|2 MeSH
650 _ 2 |a Adult
|2 MeSH
650 _ 2 |a Treatment Outcome
|2 MeSH
700 1 _ |a Kähler, Katharina C
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700 1 _ |a Gschnell, Martin
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700 1 _ |a Langan, Ewan A
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700 1 _ |a Weishaupt, Carsten
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700 1 _ |a Meiss, Frank
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700 1 _ |a Thoms, Kai-Martin
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700 1 _ |a Wahl, Renate U
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700 1 _ |a Göppner, Daniela
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700 1 _ |a Garzarolli, Marlene
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700 1 _ |a Sachse, Michael
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700 1 _ |a Schlaak, Max
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700 1 _ |a Reitmajer, Markus
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700 1 _ |a Kellner, Ivonne
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700 1 _ |a Gesierich, Anja
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700 1 _ |a Mohr, Peter
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700 1 _ |a Meier, Friedegund
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700 1 _ |a von Wasielewski, Imke
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700 1 _ |a Herbst, Rudolf
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700 1 _ |a Utikal, Jochen
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700 1 _ |a Pföhler, Claudia
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700 1 _ |a Ulrich, Jens
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700 1 _ |a Terheyden, Patrick
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700 1 _ |a Kaatz, Martin
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700 1 _ |a Haferkamp, Sebastian
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700 1 _ |a Leiter, Ulrike
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700 1 _ |a Ugurel, Selma
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700 1 _ |a Weichenthal, Michael
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700 1 _ |a Berking, Carola
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700 1 _ |a Gutzmer, Ralf
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700 1 _ |a Schadendorf, Dirk
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700 1 _ |a Nanz, Lena
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700 1 _ |a Loquai, Carmen
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