Real-world, population-based cohort study of toxicity and resource utilization of second-line ipilimumab for metastatic melanoma in Ontario, Canada.
Aged
Female
Gastrointestinal Diseases
/ chemically induced
Heart Diseases
/ chemically induced
Hospitalization
/ statistics & numerical data
Humans
Immune Checkpoint Inhibitors
/ adverse effects
Ipilimumab
/ adverse effects
Male
Melanoma
/ drug therapy
Middle Aged
Neoplasm Metastasis
Ontario
Population Surveillance
/ methods
Retrospective Studies
Skin Neoplasms
/ drug therapy
Survival Rate
comparative toxicity
immunotherapy
metastatic melanoma
real-world evidence
Journal
International journal of cancer
ISSN: 1097-0215
Titre abrégé: Int J Cancer
Pays: United States
ID NLM: 0042124
Informations de publication
Date de publication:
15 04 2021
15 04 2021
Historique:
received:
20
06
2020
revised:
20
09
2020
accepted:
30
09
2020
pubmed:
27
10
2020
medline:
3
8
2021
entrez:
26
10
2020
Statut:
ppublish
Résumé
Second-line ipilimumab has been publicly funded in Ontario for metastatic melanoma (MM) since September 2012. We examined real-world toxicity of second-line ipilimumab compared to standard second-line treatments prior to funding. MM patients who received systemic treatment from April 2005 to March 2015 were included. Patients receiving second-line ipilimumab after September 2012 were considered as cases, and those who received second-line treatment prior to the funding date were included as historical controls. Outcomes assessed include treatment-related mortality, any-cause hospital visits, ipilimumab-related hospital visits and specialist visits (eg, endocrinologists, ophthalmologists, gastroenterologists, rheumatologists and respirologists), which were captured from up to 30 and/or 90 days after end of second-line treatment. Inverse probability of treatment weighting was used to adjust for baseline differences between groups. Odds ratios (ORs) from logistic regressions and rate ratios (RRs) from rate regressions were used to assess differences between groups. We identified 329 MM patients who received second-line treatments (ipilimumab: 189; controls: 140). Ipilimumab was associated greater any-cause (60.1% vs 45.7%; OR = 1.81; P value = .019) and ipilimumab-related (47.2% vs 31.9%; OR = 1.91; P value = .011) hospital visits. Adjusting for different follow-up days, ipilimumab was associated with higher rates of all-cause (RR = 1.56 [95%CI: 1.12-2.16]), and ipilimumab-related (RR = 2.18 [95% CI: 1.45-3.27]) hospital visits. Patients receiving ipilimumab were more likely to visit specialist involved in immunotherapy toxicity management (23.5% vs 13.7%; P value = .04). Compared to historical second-line treatments, second-line ipilimumab was associated with more health service utilization (specifically hospital visits and specialist visits), suggestive of potentially increased toxicity in the real world.
Substances chimiques
Immune Checkpoint Inhibitors
0
Ipilimumab
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1910-1918Subventions
Organisme : CIHR
ID : 151290
Pays : Canada
Informations de copyright
© 2020 Union for International Cancer Control.
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