From innovation to impact: How new therapies and racial disparities shaped melanoma survival.

Abstract

e21578 Background: Melanoma remains a significant contributor to cancer-related mortality worldwide. The advent of immunotherapies, beginning with CTLA-4 inhibitor ipilimumab in 2011 among many others that followed, revolutionized melanoma treatment by enabling targeted immune responses against tumor cells. This study compares the five and ten-year relative survival rates of melanoma patients across two periods, pre- and post-era of immune checkpoint inhibitors, targeted therapies, and other advancements, to assess the impact of these therapies on long-term patient outcomes. Methods: We performed a retrospective cohort study using the SEER Research Plus Database, 22 registries, (Nov 2023, Sub 2000-2021) to calculate the relative survival rate (RSR) of melanoma in the US in two specific time intervals 2001-2010 & 2011-2020. These intervals align with significant therapeutic developments, particularly the introduction of immune checkpoint inhibitors and targeted therapies post-2011. We included malignant melanomas of all sites. Exclusion criteria encompassed cases diagnosed outside the 2001-2020 range. The year of diagnosis, sex, and race data were available for each case. Patients were stratified by sex and categorized into two racial groups: White and Black. The 60-month (5-year) and 120 months (10 year) RSRs was found for the cohort and each racial group. We calculated survival utilizing the Kaplan-Meier method. Using the log-rank test, we also found hazard ratios (HR), with the corresponding CI for each racial group stratified by sex. Results: We investigated melanoma survival rate trends for two decades while considering gender and race. The cohort relative survival analysis revealed an increased RSR from 89.6% to 92.6% at the five years, and from 87.5% to 92% at 10 years (p value <.00001). An investigation based on race revealed substantial improvements among both White and Black populations. The HR (Table1) emphasized the improved survival outcomes in both racial groups and across genders in the post-2010 treatment era. Conclusions: This study highlights the transformative impact of immunotherapies, and other novel therapeutic strategies in melanoma care, as evidenced by increased five- and ten-year survival rates in the post-2010 period. The approval and widespread clinical application of these treatments, have significantly extended survival prospects for melanoma patients, establishing these therapies as a critical component of melanoma treatment. Hazard ratios at 5- and 10-year marks, categorized by sex and race. White Male White Female Black Male Black Female HR 95% CI HR 95% CI HR 95% CI HR 95% CI 60 Months 1.207 1.179-1.235 1.179 0.895-1.555 1.039 0.745-1.449 1.074 0.788-1.465 120 Months 1.173 1.154-1.193 1.139 0.939-1.382 1.21 0.957-1.530 1.036 0.827-1.299