Treatment outcomes for metastatic melanoma patients: real-world data from a public hospital in the south of Brazil

Keywords

metastatic melanoma - treatment outcomes - chemotherapy - immunotherapy - access to care

Introduction: Melanoma, a malignant tumor originating in melanocytes, is on the rise globally. Despite increasing diagnoses, mortality rates have decreased due to advances in treatment. Genetic mutations, particularly BRAF gene mutation, are common in melanomas. Immunotherapy and targeted therapies have revolutionized treatment outcomes.

Methods: Observational study in a Brazilian public hospital analyzing melanoma treatments from 2013 to 2023. Data collected from medical records, excluding those under 18 or with non-standard treatments. Statistical analysis was performed to assess associations and survival.

Results: Study included 88 patients, mostly Caucasian and male, with a median age of 54.8 years. Majority initiated treatment due to skin lesions, with BRAF mutations observed in 61.1% of cases. First-line treatment with dacarbazine had a median survival of 2 months, compared to 9 months with immunotherapy or targeted therapy. About 44.3% received a second-line treatment, with Pembrolizumab being the most common choice.

Discussion: Findings reflect challenges in accessing advanced treatments in the Brazilian public health system. Survival outcomes in this study were lower than those reported in literature, likely due to limited access to standard therapies. Legal processes for accessing treatments prolong the time to initiate effective therapies. Immunotherapy and targeted therapies show superior outcomes compared to traditional chemotherapy for metastatic melanoma. Access to these treatments in the Brazilian public health system is crucial to improve patient outcomes, but challenges persist due to cost and availability issues.

Corresponding author: Allydson Döhl Simes (e-mail: [e-mail]).