The following is a summary of “Factors Associated with Adoption of Immune Checkpoint Inhibitor Treatment for Advanced Melanoma: A SEER-Medicare Cohort Study,” published in the July 2024 issue of Dermatology by Mohr, et al.

For a study, researchers examined patient and neighborhood characteristics to investigate variations in the utilization of immune checkpoint inhibitor (ICI) immunotherapy for advanced melanoma.

A retrospective cohort study was conducted using a deidentified, random sample of SEER-Medicare beneficiaries aged 65 years and above diagnosed with stage III or stage IV melanoma between 2011 and 2017. The primary outcome was the initiation of ICI immunotherapy (ipilimumab, pembrolizumab, nivolumab, or atezolizumab) after diagnosing stage III or stage IV melanoma. ICI usage was analyzed using multivariable logistic regression. Additionally, a secondary analysis was performed by examining the cohorts from 2011 to 2014 and 2015 to 2017 to assess potential temporal differences.

A total of 3,531 beneficiaries were included, with a mean follow-up of 2.1 (SD = 2.0) years. A higher likelihood of ICI usage was associated with male sex (OR = 1.21, 95% CI = 1.04–1.42) and a higher density of medical oncologists (OR = 1.02, 95% CI = 1.01–1.04). Conversely, a lower likelihood of ICI usage was associated with older age groups and Charlson comorbidity score (score ≥2; OR = 0.72, 95% CI = 0.60–0.86). However, these associations diminished in more recent years, with no association observed with sex, medical oncologist density, Charlson comorbidity score, and only an association with the oldest age group in the years 2015–2017.

They identified significant sex- and age-related differences in the initiation of ICI among SEER-Medicare beneficiaries with stage III or stage IV melanoma, which appeared to be improving over time.

Reference: sciencedirect.com/science/article/pii/S2667026724000365