Aims: It is unclear if outcomes of systemic treatment in advanced melanoma are significantly influenced by age. While there is data to suggest that older patients respond to and tolerate immunotherapy well (1), there is less data regarding the differential efficacy of immunotherapy in younger patients. This study aims to compare outcomes to systemic therapy (both targeted and immunotherapy) in younger (≤45) and older (≥70) patients with stage IIIc unresectable or metastatic melanoma.
Methods: A single site retrospective audit of all patients, identified from pharmacy records, with stage IIIc unresectable or metastatic melanoma treated at the Princess Alexandra Hospital with targeted and/or immunotherapy was conducted. End points were time to progression and death, and the date of starting second line treatment. Patients were divided into those aged 45 or under and 70 or older. Overall survival (OS) and progression‐free survival (PFS) were calculated using the Kaplan–Meier method.
Results: In total 122 cases since 2013 were identified with 55 patients ≤45 and 67 patients ≥70. The median OS was 16 months for patients ≤45 (95% CI 0.11 - 31.89) and 22 months for patients ≥70 (95% CI 13.77 - 30.23) with no significant difference between the two groups (p = 0.72). The median PFS in patients treated with immunotherapy was 8 months for ≤45 (95% CI 0.00 - 18.79) and 6 months for ≥70 (95% CI 0.00 - 18.22) with no significant difference (p = 0.96). Similarly, the median PFS in patients ≤45 treated with targeted therapy was 6months (95% CI 4.61 - 7.39) and 10 months (95% CI 7.50 - 12.50) for ≥70 with no significant difference (p = 0.317).
Conclusions: This retrospective audit did not demonstrate a significant difference in overall or progression free survival with unresectable/metastatic melanoma treated with targeted or immunotherapy regardless of age.