malignant melanoma: a transformation in treatment
TRANSCRIPT
PAGE 18 IMS HEALTH REAL-WORLD EVIDENCE SOLUTIONS
INSIGHTS A DEEP DIVE INTO MELANOMA
ACCESSPOINT • VOLUME 6 • ISSUE 12 PAGE 19
more detail
Malignant Melanoma in Europe
A Transformation in Treatment Regimens
Biomarkers Take Center Stage
In 2009, In 2015,
BRAF Inhibitors Dominate First-Line Treatment
treatments were mostly cytotoxic or interferon regimens
more than 1 in 2 treatments included BRAF or MEK inhibitors
The evolution toward more targeted treatments has been driven by a dramatic increase in biomarker testing – a valuable tool in identifying patients for certain therapies. Specifically, patients with BRAF-mutant status are now benefiting from BRAF and MEK inhibitors.
Available real-world data shows the dramatic impact of new drugs and genomic advances on current treatment practice in just six years; of the patients testing positive for BRAF mutation, the vast majority receive BRAF inhibitors as first-line treatment.
*Treatment with BRAF inhibitors is hindered only by delayed approval
Tested negative for BRAF mutation
Not TestedTested positive for BRAF mutation
0
20
40
60
80
100
120
0
20
40
60
80
100
120
% move to 2nd line (EU5)% move to 2nd line (GR) % move to 2nd line (UK)
vs.
60% Cytotoxic
39% Interferon
8% Other3% Anti-CTLA
- top left: show more of timeline/progress
76%EU5
France81%
Germany82%
Italy*53%
Spain76%
UK85%
The landscape of melanoma treatments has shifted significantly in a relatively short period of time, evolving to embrace targeted therapies. This trend parallels the increasing use of biomarkers and targeted therapies in other cancer types (see page 4).
16.9% Cytotoxic
53.4% Anti-CTLA-4
5.1% BRAF
2.8% BRAF+MEK inhibitors
2.2% MEK
19.7% Anti-PD(L)-1
UK
6% Cytotoxic
76.6% Anti-CTLA-4
13.4% BRAF
0.5% BRAF+MEK inhibitors
0.5% Others
3% Anti-PD(L)-1
16.1% Cytotoxic
0.1% Interferons
61.8% Anti-CTLA-4
9.2% BRAF
2.2% BRAF+MEK inhibitors
0.7% MEK
0.1% Others
9.7% Anti-PD(L)-1
EU5 Patients in 2nd Line
16.1%
61.8%9.2%
9.7%
2.2%
0.1% Others0.1% Interferon0.7% MEK inhibitor
53.4%
16.9%
19.7%
16.9%
5.1%
2.2% MEK inhibitor2.8% BRAF+MEK inhibitor
GR Patients in 2nd Line
76.6%13.4%
6%
3%
0.5% Others0.5% BRAF+MEK inhibitor
Still A Striking Variation in Second-Line Choice Other, less obvious characteristics may affect treatment decisions and switching behavior. A cross-country view of pathways for patients who fail on BRAF inhibitors reveals significant differences in second-line product choice.
Anti-PDL(L)-1Cytotoxic
BRAF+MEK inhibitor
Anti-CTLA
MEK inhibitorBRAF inhibitor
Interferon
Other
9% Cytotoxic5% Interferon
31% Anti-CTLA
44% BRAF inhibitor
7% MEK inhibitor11% Anti-PD(L)-1
Tested positive for BRAF mutation and treated with BRAF inhibitors
Tested positive for BRAF mutation
- Can turn on Grid layer to view margins (updated per David’s request)
- copy/paste pie graph above, right-click “Data...” to edit stats
- break out of pie graph by “Ungroup”
original data graphs, always copy/paste to edit
scale 80% and additional 80% smaller to create shading
In 2014, 91% of patients were tested for BRAF mutation – 55% tested positive.
Germany and the UK demonstrate very different product choices for patients who fail on first-line BRAF-in-hibitors.
A high proportion of eligible patients are given BRAF-inhibitors
Dorothea Von Bredow – Engagement Manager, IMS HealthNikolas Kolb – Analyst, RWE Solutions, IMS HealthMathis Bernhardt, PHD – Analyst, RWE Solutions, IMS HealthNina Schmidt, XX, MSC – Senior Consultant, RWE Solutions, IMS Health
Dorothea Von Bredow – Engagement Manager, IMS HealthNikolas Kolb – Analyst, RWE Solutions, IMS HealthMathis Bernhardt, PHD – Analyst, RWE Solutions, IMS HealthNina Schmidt, XX, MSC – Senior Consultant, RWE Solutions, IMS Health
Dorothea von Bredow, PHD – Director, RWE Solutions, IMS [email protected] Kolb, MSC – Analyst, RWE Solutions, IMS [email protected]
Mathias Bernhardt, PHD – Analyst, RWE Solutions, IMS [email protected] Schmidt, MSC – Senior Consultant, RWE Solutions, IMS Health [email protected]
Source all data: IMS RWD Oncology Analyzer
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