Objectives. To determine the effect of new therapies and trends toward reduced mortality rates of melanoma.
Methods. We reviewed melanoma incidence and mortality among Whites (the group most affected by melanoma) in 9 US Surveillance, Epidemiology, and End Results registry areas that recorded data between 1986 and 2016.
Results. From 1986 to 2013, overall mortality rates increased by 7.5%. Beginning in 2011, the US Food and Drug Administration approved 10 new treatments for metastatic melanoma. From 2013 to 2016, overall mortality decreased by 17.9% (annual percent change [APC] = −6.2%; 95% confidence interval [CI] = −8.7%, −3.7%) with sharp declines among men aged 50 years or older (APC = −8.3%; 95% CI = −12.2%, −4.1%) starting in 2014. This recent, multiyear decline is the largest and most sustained improvement in melanoma mortality ever observed and is unprecedented in cancer medicine.
Conclusions. The introduction of new therapies for metastatic melanoma was associated with a significant reduction in population-level mortality. Future research should focus on developing even more effective treatments, identifying biomarkers to select patients most likely to benefit, and renewing emphasis on public health approaches to reduce the number of patients with advanced disease.
- Juliana Berk-Krauss is with The State University of New York Downstate Medical Center, Brooklyn. Juliana Berk-Krauss, Jennifer A. Stein, and David Polsky are with The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, NY. Jeffrey Weber is with the Department of Medicine, New York University School of Medicine. Jennifer A. Stein, Jeffrey Weber, and David Polsky are with The Laura and Isaac Perlmutter Cancer Center, New York University School of Medicine, NYU Langone Health, New York. Alan C. Geller is with the Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health, Boston, MA.