Treatment patterns, outcomes, and resource utilization of patients with metastatic melanoma in the U.K.: The MELODY study

Background Advanced melanoma is an aggressive disease with a poor prognosis. Approved therapy is limited in the U.K. and, until recently, no treatment had improved survival over best supportive care. A deeper understanding of current clinical practice will help new agents find a place in future treatment pathways. Objectives To document U.K. clinical practice for the treatment of patients with unresectable stage III/IV (advanced) melanoma. Methods MELODY (melanoma treatment patterns and outcomes among patients with unresectable stage III/IV disease: a retrospective longitudinal survey) compiled registries of consecutive patients with malignant melanoma (any stage) between 1 July 2005 and 30 June 2006 from France, Italy and the U.K. Patients with advanced melanoma and ≥ 2 months of follow-up were eligible for analysis. Results There were 220 eligible patients identified in the U.K., of whom 117 (53·2%) received systemic therapy outside of clinical trials. Over half of these patients received dacarbazine as first- or second-line therapy. Healthcare-resource utilization was extensive and patients had short survival times: 1- and 2-year survival rates after first-line systemic treatment were 45·5% [95% confidence interval (CI) 37·1-53·6] and 24·7% (95% CI 17·7-32·3), respectively. Conclusions Systemic and palliative treatments used to manage advanced melanoma in the U.K. are associated with considerable healthcare resource utilization and poor short-term survival. What's already known about this topic? Historically, patients with advanced melanoma have had a very poor prognosis, with limited treatment options outside of clinical trial participation. What does this study add? MELODY is the first observational study to provide a detailed description of treatment patterns and outcomes among U.K. patients with advanced melanoma treated in routine clinical practice, providing a historical context for assessing outcomes in the modern era of targeted agents and immunotherapies. © 2013 British Association of Dermatologists.