Treatment Pattern Of Systemic Therapies In Patients With Metastatic Melanoma And Braf Mutation Test.

e21003 Background: The National Comprehensive Cancer Network (NCCN) recommends systemic therapy, including target therapy, immunotherapy, and chemotherapy, for metastatic melanoma (MM). BRAF mutations help inform the choice of therapy. This study aims to to describe the treatment pattern of mm patients before and after BRAF testing in the US. Methods: Two retrospective cohort studies were conducted using MarketScan commercial and Medicare supplemental databases and IMS PharMetrics Plus databases. Patients included those aged ≥ 18 years who had ≥ 1 mm diagnosis and received BRAF testing after mm diagnosis from August 1, 2011 to September 30, 2015. Patients with non-melanoma primary malignancy were excluded. Patients who received BRAF testing were identified based on Current Procedural Terminology (CPT) codes. Systemic therapies before and after BRAF testing were compared. Cost of the test and time from test to systemic therapy were evaluated. Results: 1,577 and 919 mm patients who received BRAF testing were included from MarketScan and Pharmetrics, respectively. Results from MarketScan analysis were as follows: the most recent systemic therapies before test were: no systemic therapy 96.3%; target therapy 0.3%; immunotherapy 2.5%; chemotherapy 1.0%, while the most recent systemic therapies after test were 58.4%, 12.1%, 23.0% and 6.5%, respectively. Median time from diagnosis to test and from test to the therapy was 34 and 47 days, respectively. The mean (±SD) costs of test was $515 (±$1011). Results from PharMetrics were similar. Conclusions: After BRAF testing, mm patients were more likely to receive systemic therapy. Many mm patients remained untreated after BRAF testing. MarketScan (N = 1577) Pharmetrics (N = 919) Age [mean, std] 57 13 57 12 Male 967 61% 577 63% Median days from mm diagnosis to test 34 36 Median days from test to systemic therapy 47 48 BRAF test cost [mean, std] $515 $1,011 $637 $1,227 Systemic therapy BEFORE test Target therapy 5 0.3% 5 0.5% Immunotherapy 39 2.5% 15 1.6% Chemotherapy 15 1.0% 64 7.0% No systemic therapy 1518 96.3% 835 90.9% First systemic therapy AFTER test Target therapy 191 12.1% 113 12.3% Immunotherapy 362 23.0% 179 19.5% Chemotherapy 103 6.5% 85 9.2% No systemic therapy 921 58.4% 542 59.0%