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Comment & Response
August 2018

Interpreting the Association of First-in-Class Immune Checkpoint Inhibition and Targeted Therapy With Survival in Patients With Stage IV Melanoma

Author Affiliations
  • 1Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
  • 2Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
  • 3Division of Gerontology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts
  • 4Department of Biostatistics, Harvard University, Boston, Massachusetts
JAMA Oncol. 2018;4(8):1135-1136. doi:10.1001/jamaoncol.2018.0881

To the Editor The immune checkpoint and targeted BRAF/MEK pathway inhibitors became available to patients with melanoma in the United States in 2011. Sinnamon and colleagues1 studied the association of these novel treatments with patient outcomes at a population level. Because compared with those who received a diagnosis during 2004 through 2008, patients who received a diagnosis during 2011 through 2012 were more commonly treated with immunotherapies, they used survival data of patients with stage IV melanoma from the National Cancer Database to compare the overall survival profile of patients who received a diagnosis in 2011 through 2012 with those in historical cohorts (diagnosed in 2004-2008 and in 2009-2010). Overall survival was statistically significantly longer for the 2011 through 2012 cohort compared with either the 2009 through 2010 or 2004 through 2008 groups (2011-2012 vs 2009-2010: hazard ratio [HR], 0.89; 95% CI, 0.84-0.94; P < .001; 2011-2012 vs 2004-2008: HR, 0.85; 95% CI, 0.81-0.89; P < .001). Due to other confounding factors, such an increase in survival might not totally be credited to immunotherapies, but this study provides an interesting way to explore the association of survival benefit from these new therapies on a population level.

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