Table 3.
Second-Line, Systemic Therapy Utilization and Number of Months by BRAF Status, Metastatic Melanoma, 2019
| Regimen | USA | WE | ||||||
|---|---|---|---|---|---|---|---|---|
| BRAF Wildtype or Unknown | BRAF Mutant | BRAF Wildtype or Unknown | BRAF Mutant | |||||
| Utilization | No. of Months | Utilization | No. of Months | Utilization | No. of Months | Utilization | No. of Months | |
| Conventional chemotherapy/cytokines | ||||||||
| Sorafenib, carboplatin, paclitaxel | 4.3% | 6.6 | 4.3% | 6.9 | * | – | * | – |
| Sorafenib, dacarbazine | 3.1% | 4.2 | * | – | * | * | – | |
| IFNa-2a& | * | – | * | – | 3.1% | 4.5 | * | – |
| paclitaxel | 6.6% | 5.3 | * | – | 3.4% | 8.5 | * | – |
| cisplatin, dacarbazine, carmustine, IL-2, IFNa | * | – | * | – | 4.2% | 11.1 | * | – |
| CVD# | * | – | * | – | 3.5% | 8.3 | * | – |
| temozolomide | 17.4% | 5.5 | * | – | 5.2% | 6.5 | * | – |
| dacarbazine, IFNa&, tamoxifen | * | – | * | – | 3.4% | 6.0 | * | – |
| Dartmouth regimen## | 8.2% | 6.5 | 5.4% | 6.6 | * | - | * | – |
| dacarbazine | * | – | * | – | 8.7% | 6.9 | * | – |
| Other chemotherapy$ | 5.4% | – | 4.8% | – | 8.7% | – | 11.7% | – |
| Total CC/OI | 45.0% | 14.4% | 40.2% | 11.7% | ||||
| Target therapy | ||||||||
| Cobimetinib, Vemurafenib | 0.0% | – | 8.7% | 8.1 | 0.0% | – | 5.3% | 8.1 |
| Dabrafenib, Trametinib | 0.0% | – | 19.6% | 7.9 | 0.0% | – | 11.0% | 10.5 |
| Dabrafenib | 0.0% | – | 1.4% | 5.8 | 0.0% | – | 2.4% | 8.8 |
| Encorafenib, Binimetinib | 0.0% | – | 5.5% | 7.9 | 0.0% | – | 3.1% | 9.7 |
| Trametinib | 0.0% | – | 0.2% | 14.0 | 0.0% | – | 5.5% | 9.0 |
| Vemurafenib | 0.0% | – | 2.1% | 9.0 | 0.0% | – | 4.7% | 8.1 |
| Total target | 0.0% | 37.6% | 0% | 32% | ||||
| Immunotherapy | ||||||||
| Ipilimumab, dacarbazine | 1.4% | 7.5 | 0.4% | 3.0 | 2.1% | 6.3 | 1.1% | 4.0 |
| Nivolumab, Ipilimumab | 17.5% | 7.3 | 12.9% | 8.9 | 15.0% | 9.9 | 12.1% | 10.2 |
| Ipilimumab | 10.8% | 6.3 | 5.1% | 5.8 | 13.4% | 8.0 | 7.2% | 6.9 |
| Nivolumab | 5.5% | 8.4 | 14.6% | 7.1 | 12.8% | 9.3 | 18.9% | 12.0 |
| Pembrolizumab | 10.6% | 8.1 | 12.2% | 7.8 | 11.5% | 10.5 | 14.4% | 10.1 |
| Total immunotherapy | 45.8% | 45.1% | 54.9% | 53.7% | ||||
| Other | ||||||||
| Talimogene laherparepvec | 4.3% | 5.2 | 0.2% | 4.0 | 1.0% | 10.0 | 0.5% | 9.7 |
| Investigational Drug (Clinical Trial) | 4.8% | — | 2.7% | — | 4.0% | — | 2.1% | — |
| Total other | 9.2% | 2.9% | 5.0% | 2.6% | ||||
Notes: $Other chemotherapy includes many different schemes, with dacarbazine, interferon, interleukin, vinblastine, paclitaxel, carboplatin, alone in combined; excludes combinations with newer immunotherapies (pembrolizumab, nivolumab, ipilimumab etc) and targeted therapy. #CVD – Cisplatin, vinblastine, dacarbazine. % IL2 – Interleukin 2. &IFNa – Interferon alpha. *less than 3%. ##Dartmouth regimen is a combination of chemotherapy with cytokines agents in high dose.
Abbreviation: CC, conventional chemotherapy.