Abstract
160
Background: Interleukin-2 (IL-2) has been the predominant immunotherapy used for stage IV melanoma for the past decades, with newer immunotherapy drugs approved within the past five years. By using the National Cancer Database (NCDB), our study aims to be the largest to determine the impact of immunotherapy on patients with stage IV melanoma. To examine only IL-2 and interferon-alpha, only patients diagnosed prior to 2011 were used. Methods: 10,771 patients diagnosed with stage IV melanoma between 2004-2010 were identified with sufficient data. 1,009 of these patients were given immunotherapy. Chi-square analysis was used to determine demographic differences between those with and without immunotherapy. Between-therapy survival differences were estimated by the Kaplan-Meier method and associated log-rank tests; Tukey-Kramer adjusted p < .05 indicated statistical significance. Results: Patients with immunotherapy had a median survival of 17.4 months, while those without immunotherapy had a median survival of 7.1 months. 27% of patients given immunotherapy were alive three years post diagnosis, compared to only 14% of patients who were not given immunotherapy. Immunotherapy patients had a greater percentage of those with private insurance (65.3% vs. 37.7%, p<0.001), an income greater than $63,000 (40.5% vs. 31.9%, p<0.001), and no comorbidities (87.3% vs. 77.5%, p<0.001) compared to patients not given immunotherapy. Conclusions: Patients with immunotherapy had nearly a 2.5-fold increase in median survival compared to patients not provided immunotherapy. Compared to those without immunotherapy, immunotherapy patients lived in more wealthy and educated zip codes, and had more private insurance. [Table: see text]