Following a 7.5% increase in melanoma-related deaths among white Americans between 1986 and 2013, researchers have now found a nearly 18% decline over the following 3 years. This improvement can be attributed to significant advances in treatment, according to researchers from New York University (NYU) Grossman School of Medicine, NYU Langone’s Perlmutter Cancer Center, and Harvard University.1

Whereas other cancers have seen significant declines, including prostate, breast, and lung cancer, the authors said the sharp decline in deaths due to melanoma outstrips all of those decreases.1

Melanoma is one of the most common forms of cancer in the United States, affecting almost entirely white Americans, and has been historically difficult to treat after metastasizing.1 Newer therapies have been much more effective than traditional chemotherapy, though they come with higher price tags. The new drugs include those that target the BRAF gene, which is mutated in nearly half of patients with melanoma, and immune checkpoint inhibitors.1

The researchers analyzed data collected by the National Cancer Institute and CDC on new cases and deaths due to melanoma spanning from 1986 to 2016 and including nearly 1 million Americans.1

Notably, the FDA approved 10 new treatments for metastatic melanoma beginning in 2011, shortly before the decline began in 2013. Between 2013 and 2016, overall mortality decreased by 17.9%, with the sharpest declines found among men aged 50 years or older starting in 2014.2

“Our findings show how quickly patients and physicians accepted these new drugs because they profoundly reduce death from melanoma,” said David Polsky, MD, PhD, co-senior study author, in a statement. “These therapies are now considered the backbone of how we treat this cancer.”1

Polsky added that the decrease cannot be explained by improving detection methods because the death rates dropped sharply, rather than steadily over time.1

The authors also noted that the newer treatments lead to substantial health care costs.1 According to an earlier literature review published by the National Center for Biotechnology Information, treatment costs can vary widely but are typically highest among patients diagnosed with late-stage melanoma and in the initial and terminal phases of care.3

Among studies examining the annual cost of melanoma care in the United States, cost estimates ranged from $44.9 million among Medicare patients with existing cases to $932.5 million among newly diagnosed cases across all age groups.3  

Regardless of improvements in treatment options, Polsky and the other researchers said early detection is vital because it can allow for less toxic forms of treatment and lowered health care costs. Prevention is also important to reduce the risk of melanoma, including avoiding excess UV light exposure.1

Polsky added that future studies should examine socioeconomic factors that may limit access to the newer therapies, as well as the efficacy of these treatments on other ethnic groups.1

REFERENCES
  1. America Sees Record Lows of Deaths Due to Melanoma [news release]. New York University Langone Health; March 19, 2020. https://nyulangone.org/news/america-sees-record-lows-deaths-due-melanoma. Accessed March 24, 2020.
  2. Berk-Krauss J, Stein J, Weber J, Polsky D, et al. New Systematic Therapies and Trends in Cutaneous Melanoma deaths Among US Whites, 1986-2016. American Journal of Public Health; March 19, 2020. https://ajph.aphapublications.org/doi/10.2105/AJPH.2020.305567. Accessed March 24, 2020.
  3. Guy G, Ekwueme D, Tangka F, Richardson L. Melanoma treatment Costs: A Systematic Review of the Literature. American Journal of Preventive Medicine; July 8, 2015. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4495902/. Accessed March 24, 2020.