This year an estimated 1,230 British Columbians will be newly diagnosed with melanoma. Although preventable and curable if caught early, advanced melanoma can be fatal. Last year, Dr. Doran Ksienski, medical oncologist at BC Cancer – Victoria, established the BC Cancer Melanoma Immunotherapy Database to better understand advanced melanoma and immunotherapy treatment options after finding that many patients receiving care at BC Cancer were older, sicker, and had more concurrent medical conditions than those who received the treatments through clinical trials.
“Clinical trials have clearly shown that immunotherapy improves survival for patients with advanced melanoma,” says Ksienski. “However important questions remain regarding how safe and effective immunotherapy medications are in the type of patients I see in my practice. I created the BC Cancer Melanoma Immunotherapy Database to better understand how often a typical patient may experience an adverse effect, the need to potentially pause treatments because of side-effects, and survival outcomes for patients who receive specific combinations of anticancer treatments.”
The database uses statistics collected from nearly 400 BC Cancer patients. In 2021, Dr. Ksienski published two papers on the newly created database. One paper, published in Clinical Oncology
, showed that patients who experienced serious side effects from a combination immunotherapy treatment had better survival outcomes compared to patients who did not have any side effects. Another study, published in the Journal of Geriatric Oncology
, demonstrated that the frequency of adverse events for patients undergoing immunotherapy treatment for advanced melanoma was similar for people over the age of 75 as it was for people under 75.
“Immunotherapy has brought real hope to patients with advanced melanoma and some patients are able to live many years,” says Dr. Ksienski. “I am routinely treating patients in their 80s and sometimes in their early 90s. Older patients are sometimes reluctant to undergo chemotherapy because of concerns about side effects and quality of life, however, information from the database suggests age is not a barrier to receive immunotherapy.”
With the expansion of virtual health services, Dr. Ksienski would like to see more research into whether patients followed via telemedicine are at higher risk of developing treatment side-effects than those who are seen in person.
He credits the success of the BC Cancer Melanoma Immunotherapy Database to the high level of expertise and contributions of a multidisciplinary including: medical oncologists, radiation oncologists, pathologists, internal medicine residents, and biostatisticians.