9083 Background: We seek to characterize tx patterns for patients (pts) with early stage (ES) and advanced stage (AS) malignant melanoma (MM). MarketScan is a large insurance claims database with complete diagnosis (dx) and tx information. Methods: Using MarketScan data, pts were identified between Jan 2001 and Jun 2011 using ≥1 inpatient or ≥2 outpatient MM ICD9 codes ≥6 weeks apart. Pts with a history of other malignancies or lacking records at least 1 year prior to diagnosis were excluded. Pts were considered AS if they received chemotherapy, interferon, ≥2 days of MM surgery, or a code of secondary metastases. All other pts were classified as ES. Radiotherapy, immunotherapy, chemotherapy, and surgery type were identified with HCPCS, CPT, and ICD9 procedure codes. Pts were categorized by type of progression (ToP): AS at time of dx (AS-D), ES at dx with progression to AS during follow-up (ES-P), and ES at dx with no progression during follow up (ES-NP). Results: Of 30,678 eligible pts, 55% were male, median age was 59 yrs, and median follow-up was 31 months. Initial disease locations were head and neck (21%), torso (27%), upper extremities (17%), and lower extremities (14%). Twenty-five percent (7607 pts) were identified as having AS MM during follow-up. Of these, 2,445 (8%) were AS-D, while 5162 (17%) were ES-P. The remaining 23,071 pts (75%) were ES-NP. Frequency of most extensive surgery type after diagnosis date are shown by ToP (table). No ES-NP pts received systemic tx during follow-up, but 21% of ES-P and 64% of AS-D pts received either chemotherapy, immunotherapy, or both. Agents most commonly prescribed in AS pts were interferon and temozolomide. Conclusions: The tx burden in MM pts is extensive and appears to increase with disease severity. Claims data can be a valuable tool in elucidating MM tx patterns by disease stage. [Table: see text]
Increase of lymphocytes and eosinophils, and decrease of neutrophils at an early stage of anti-PD-1 antibody treatment is a favorable sign for advanced malignant melanoma
