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Some Advanced Melanoma Patients Start Systemic Therapy Shortly Before Death

Reduced odds of receiving immune therapy seen in association with female sex, elevated LDH, BRAF mutation, poor ECOG performance status

By Dermsquared Editorial Team | January 10, 2024

WEDNESDAY, Jan. 10, 2024 -- A considerable number of patients with advanced melanoma start systemic therapy in the 30 days or three months before death, according to a study published online Dec. 11 in the Journal of Dermatology.

Pieter E.A. van Lith, from the Netherlands Comprehensive Cancer Organization in Utrecht, and colleagues examined the timing of systemic therapies within 30 days and three months before death in patients diagnosed with advanced melanoma (July 2017 to June 2020) who died before July 2020.

Sixty-eight percent of the 1,097 patients received systemic therapy. Almost 25 and 10 percent started a new therapy within 90 and 30 days before death, respectively. The researchers found that the odds of receiving immune therapy were reduced in association with female sex, elevated lactate dehydrogenase, BRAF mutation, poor Eastern Cooperative Oncology Group performance status, and high comorbidity index. The odds of receiving both targeted and immune therapies were highest for patients younger than 40 years.

"It is crucial to carefully consider the potential benefits and drawbacks of initiating these novel therapies in the final stages of life, emphasizing the importance of shared decision-making between patients and their health care providers," the authors write.

One author disclosed ties to the pharmaceutical industry.

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