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The impact of patient characteristics and disease-specific factors on first-line treatment decisions for BRAF-mutated melanoma: results from a European expert panel study
- Source :
- Melanoma Research, Repositorio Institucional de la Consejería de Sanidad de la Comunidad de Madrid, Consejería de Sanidad de la Comunidad de Madrid, Ascierto, P A, Bastholt, L, Ferrucci, P F, Hansson, J, Márquez Rodas, I, Payne, M, Robert, C, Thomas, L, Utikal, J S, Wolter, P, Kudlac, A, Tuson, H & McKendrick, J 2018, ' The impact of patient characteristics and disease-specific factors on first-line treatment decisions for BRAF-mutated melanoma : Results from a European expert panel study ', Melanoma Research, vol. 28, no. 4, pp. 333-340 . https://doi.org/10.1097/CMR.0000000000000455
- Publication Year :
- 2018
-
Abstract
- Supplemental Digital Content is available in the text.<br />Treatment decisions for advanced melanoma are increasingly complex and guidelines provide limited advice on how to choose between immunotherapy and targeted therapy for first-line treatment. A Delphi study was carried out to understand which patient characteristics and disease-related factors inform clinicians’ choices of first-line treatment for BRAF-mutated melanoma. Twelve European melanoma specialists experienced in using immunotherapies and targeted agents participated in a double-blind two-phase Delphi study. In phase 1, participants completed a questionnaire developed after reviewing patient characteristics and disease-related factors reported in trials, clinical guidelines, and health technology assessments. Phase 2 was an expert panel meeting to explore outstanding issues from phase 1 and seek consensus, defined as 80% agreement. Twenty patient-related and disease-related characteristics were considered. There was consensus that tumor burden (83% of clinicians) and disease tempo (83%) are very or extremely important factors when selecting first-line treatment. Several components were deemed important when assessing tumor burden: brain metastases (82% of clinicians) and location of metastases (89%). There was consensus that disease tempo can be quantified in clinical practice, but not on a formal classification applicable to all patients. Lactate dehydrogenase level is a component of both tumor burden and disease tempo; all clinicians considered lactate dehydrogenase important when choosing first-line treatment. The majority (92%) did not routinely test programmed death ligand-1 status in patients with melanoma. Clinicians agreed that choosing a first-line treatment for advanced melanoma is a complex, multifactorial process and that clinical judgment remains the most important element of decision-making until research can provide clinicians with better scientific parameters and tools for first-line decision-making.
- Subjects :
- Disease specific
Male
Proto-Oncogene Proteins B-raf
advanced melanoma
Cancer Research
medicine.medical_specialty
Skin Neoplasms
BRAF/MEK inhibitors
medicine.medical_treatment
Delphi method
Patient characteristics
Dermatology
Targeted therapy
030207 dermatology & venereal diseases
03 medical and health sciences
0302 clinical medicine
Double-Blind Method
Surveys and Questionnaires
medicine
Humans
Intensive care medicine
Melanoma
Advanced melanoma
business.industry
factors
selecting therapy
medicine.disease
ORIGINAL ARTICLES: Clinical research
expert opinion
First line treatment
Europe
Oncology
first-line treatment decision
030220 oncology & carcinogenesis
ComputingMethodologies_DOCUMENTANDTEXTPROCESSING
Female
Treatment decision making
immunotherapy
business
checkpoint inhibitors
Subjects
Details
- ISSN :
- 14735636
- Volume :
- 28
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- Melanoma research
- Accession number :
- edsair.doi.dedup.....9ee4e9e62e780a228a3f3cccf6e9e120
- Full Text :
- https://doi.org/10.1097/CMR.0000000000000455