Background: Metastatic melanoma is an aggressive disease with a median survival in untreated Stage IV patients of only 6–9 months. Recent therapeutic developments in immunotherapy and targeted therapy have shown substantial improvement in response in metastatic melanoma. The current project intends to determine the benefit of the introduction of these new molecules in advanced melanoma across several regions of Switzerland.

Methods: This is a retrospective multi-center analysisof 328 Swiss advanced melanoma patients treated with standard chemotherapy, checkpoint inhibitors (anti CTLA-4 or anti PD1 antibodies) and kinase inhibitors (Vemurafenib, Dabrafenib/Trametinib, Encorafenib and Binimetinib) either in first or second line setting from January 2008 until June 2013.

Results: Median overall survival (mOS) from date of diagnosis of metastatic melanoma of all patients was 13.4 months. mOS of patients treated either with checkpoint or kinase inhibitors (n = 196, 17.1 months) between 2008-2013 was significantly prolonged (p < 0.001) compared to patients treated with standard chemotherapy within 2008-2009 (n = 88, 9.4 months). There was no significant difference in survival in BRAF mutated and wildtype patients (mOS 14.0 and 15.3 months, respectively, p = 0.84). 284 patients were further analyzed for survival in terms of treatments. One-year-survival was 71% (CI 60-79%) in 100 patients treated with ipilimumab, 55% (CI 45-65%) in 96 patients treated with targeted therapies and 37% (CI 27-48%) in 88 patients treated with standard chemotherapy. Proportion of patients surviving 2 years was 33% for patients treated with ipilimumab, 24% for patients with targeted therapy, and 14% in patients treated with chemotherapy.

Conclusions: Treatments with check-point and kinase inhibitors beyond clinical trials significantly improve mOS and are consistent with published prospective data. Survival is independent from BRAF mutation status alone. National melanoma registries and cancer statistics are useful for monitoring outcomes of approved therapies or newly established treatment protocols across multiple institutions and patient populations.