Real-world clinical outcomes of anticancer treatments and prognostic factors in patients with advanced melanoma in China

Purpose: China has much lower 5-year survival rates among melanoma patients than Western countries. This retrospective study describes real-world clinical outcomes and prognostic factors in locally advanced/metastatic melanoma in China. Materials and methods: Adults patients with unresectable stage III or IV melanoma treated between January 1, 2014 and December 31, 2015, at the Beijing Cancer Hospital were eligible (data cutoff: December 31, 2017). The Kaplan-Meier method and Log-Rank test were used to estimate the median value of time-to-event outcomes. A Cox proportional hazards model was simulated to evaluate associations of patients' characteristics with survival. Results: Overall, there were 221 and 116 Chinese locally advanced and/or metastatic melanoma patients were enrolled in the first line (1L) and the second line (2L) treatments, respectively. The real-world objective response rate was <10% (1L: 6.3%; 2L: 3.4%); median progression-free survival was under 4 months (1L: 3.5; 2L: 2.3); median overall survival (OS) was <1 year (1L: 10.5; 2L: 7.5) with a low 12-month OS rate (43.5% for 1L, 30.5% for 2L). Based on univariate analyses, those with Eastern Cooperative Oncology Group (ECOG) Performance Status >= 2 (vs. ECOG=0) in 1L, and 2L treatment (vs. 1L treatment) or ECOG >= 2 (vs. ECOG=1) among 1L/2L were associated with statistically significantly worse outcomes. Conclusion: The current clinical outcomes in advanced melanoma patients in China are poor. High ECOG performance score independently increase risk of death both from 1L and 2L treatments, suggesting a high unmet medical need for immunotherapy in advanced melanoma.