Evidence map›Paper›PMID 38380358›Full record

ArticleFrontiers in oncology2024

Immunotherapy utilization in stage IIIA melanoma: less may be more.

Alexander E Frey, Daniel M Kerekes, Sajid A Khan, Thuy T Tran, Harriet M Kluger, James E Clune, Stephan Ariyan, Mario Sznol, Jeffrey J Ishizuka, Kelly L Olino

Open access · goldAbstract read
In one paragraph

Article in Frontiers in oncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.6field-weighted citation impact, top 32% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 2 citations in OpenAlex.

  1. Review
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 1 institution in 1 country.

Alexander E Frey *Department of Surgery, Yale University School of Medicine, New Haven, CT, United States.
Daniel M Kerekes *Department of Surgery, Yale University School of Medicine, New Haven, CT, United States.
Sajid A KhanDepartment of Surgery, Yale University School of Medicine, New Haven, CT, United States.
Thuy T TranDepartment of Medicine (Medical Oncology), Yale University School of Medicine, New Haven, CT, United States.
Harriet M KlugerDepartment of Medicine (Medical Oncology), Yale University School of Medicine, New Haven, CT, United States.
James E CluneDepartment of Surgery, Yale University School of Medicine, New Haven, CT, United States.
Stephan AriyanDepartment of Surgery, Yale University School of Medicine, New Haven, CT, United States.
Mario SznolDepartment of Medicine (Medical Oncology), Yale University School of Medicine, New Haven, CT, United States.
Jeffrey J IshizukaDepartment of Medicine (Medical Oncology), Yale University School of Medicine, New Haven, CT, United States.
Kelly L OlinoDepartment of Surgery, Yale University School of Medicine, New Haven, CT, United States.
Yale University · US

Funding

Yale Clinical and Translational Science Award (U Component)UL1TR001863 · NCATS · YALE UNIVERSITY · PI John H. Krystal, LUCILA OHNO-MACHADO · 2016 to 2026
$102.9M
NCATS NIH HHS UL1 TR001863
6 · The paper itself

Abstract

Background: Immunotherapy agents are approved for adjuvant treatment of stage III melanoma; however, evidence for survival benefit in early stage III disease is lacking. Current guidelines for adjuvant immunotherapy utilization in stage IIIA rely on clinician judgment, creating an opportunity for significant variation in prescribing patterns. This study aimed to characterize current immunotherapy practice variations and to compare patient outcomes for different prescribing practices in stage IIIA melanoma. Study design: Patients with melanoma diagnosed from 2015-2019 that met American Joint Committee on Cancer 8th edition criteria for stage IIIA and underwent resection were identified in the National Cancer Database. Multiple imputation by chained equations replaced missing values. Factors associated with receipt of adjuvant immunotherapy were identified. Multivariable Cox proportional hazards regression compared overall survival across groups. Results: Of 4,432 patients included in the study, 34% received adjuvant immunotherapy. Patients had lower risk-adjusted odds of receiving immunotherapy if they were treated at an academic center (OR=0.48, 95%CI=0.33-0.72, p<0.001 vs. community facility) or at a high-volume center (OR=0.69, 0.56-0.84, p<0.001 vs. low-volume). Immunotherapy receipt was not associated with risk-adjusted survival (p=0.095). Moreover, patients treated at high-volume centers experienced longer overall risk-adjusted survival than those treated at low-volume centers (HR=0.52, 0.29-0.93, p=0.030). Risk-adjusted survival trended toward being longer at academic centers than at community centers, but the difference was not statistically significant. Conclusion: Academic and high-volume centers utilize significantly less adjuvant immunotherapy in stage IIIA melanoma than community and low-volume centers without compromise in overall survival. These findings suggest that this population may benefit from more judicious immunotherapy utilization.

Indexed as

guidelinesimmunotherapymelanomaskin cancertreatment

Identifiers

PMID38380358
PMCPMC10876869
OpenAlexW4391571926

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.