Treatment patterns and outcomes in advanced melanoma in UK: a retrospective longitudinal survey (MELODY study)


Session type:

Mark Middleton1, Maria Marples1, Mark Harries1, John Wagstaff1, Angus Dalgleish1, Richard Osborne1, Anthony Maraveyas1, Steve Nicholson1, Neville Davidson1, Qing Wang1, Urmi Bapat1, Paul Lorigan1
1Oxford NIHR Biomedical Research Centre, Oxford, United Kingdom,2Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom,3St Thomas’ Hospital, London, United Kingdom,4Singleton Hospital, Swansea, United Kingdom,5St George’s Hospital, London, United Kingdom,6Dorset Cancer Centre, Poole, United Kingdom,7The Princess Royal Hospital, Hull, United Kingdom,8University Hospitals of Leicester, Leicester, United Kingdom,9Broomfield Hospital, Essex, United Kingdom,10Bristol-Myers Squibb Pharmaceuticals, Uxbridge, United Kingdom,11Bristol-Myers Squibb Pharmaceuticals, Uxbridge, United Kingdom


We studied treatment patterns and outcomes in unresectable stage III / IV melanoma patients diagnosed between July 2005 and June 2006 via a multinational observational retrospective survey. 


Data were collected from 31 centres in UK, France and Italy. Of 776 eligible patients, 220 were from 10 UK centres whose demographics and treatments are included. Outcome data are available for patients who received systemic therapy outside a clinical trial. OS was defined as time from date of diagnosis.


Of the UK study population, 15.9% had unresectable stage III / IV melanoma at first diagnosis. The majority of patients were of good performance status (95.3% ECOG 0-1). With the exception of LDH, baseline characteristics were generally similar across countries.

The majority of UK patients (65.9%) received first line systemic therapy, though this was less than France (89.6%) and Italy (91.7%).  32.6% of these UK patients entered clinical trials compared to 31.8% across all countries. Outside of trials, dacarbazine was the most commonly used agent in all countries. In the UK, interferon and temozolamide were next most frequent compared to fotemustine in France and Italy.

Of those who received first-line treatment in UK, 39% continued onto second-line therapy compared to 51.1% across all countries. Of these, 34.6% of patients in the UK entered trials versus 18.4% for all countries. Outside of trials, treatment patterns were similar to first-line.

Median OS by Kaplan-Meier analysis, was similar across all countries (UK 16.3 [13.2-19.0] months; all countries 17.0 [15.0-22.2] months).


These results demonstrate that patient demographics, treatment patterns and survival were broadly similar across France, Italy and UK. Fewer patients in the UK were offered first line chemotherapy. Specific differences were found in some parameters such as LDH levels and numbers entering trials across countries. More detailed analysis will be presented.