Real-world results of first-line immunotherapy or targeted therapy for metastatic melanoma in Finland: a cohort study

Aim: First-line (1L) immunotherapy has yielded superior overall survival (OS) in metastatic melanoma (MM) but some patients are ineligible for immunotherapy or need rapid response with 1L targeted therapy (TT). Materials & methods: Retrospective cohort study of real-world patients treated with 1L immunotherapy (144 BRAF wild type, 85 BRAF-mutated) or 1L TT (143 BRAF-mutated) for MM in Finland during 2014–2021. Results: Baseline brain metastases, liver metastases and elevated LDH were less common, 2-year OS rates were higher (60.3–63.5% vs. 33.8%) and more patients were alive without the next-line treatment (38.0–43.8% vs. 23.3%) in patients with 1L immunotherapy. Conclusion: Real-world patients with 1L immunotherapy for MM had favorable baseline characteristics and better treatment outcomes than observed in patients with 1L TT.