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01-12-2021 | Melanoma | Research

Adjuvant immunotherapy recommendations for stage III melanoma: physician and nurse interviews

Authors: Ann Livingstone, Kathy Dempsey, Martin R. Stockler, Kirsten Howard, Georgina V. Long, Matteo S. Carlino, Alexander M. Menzies, Rachael L. Morton

Published in: BMC Cancer | Issue 1/2021

Abstract

Background

Adjuvant immunotherapy is revolutionising care for patients with resected stage III and IV melanoma. However, immunotherapy may be associated with toxicity, making treatment decisions complicated. This study aimed to identify factors physicians and nurses considered regarding adjuvant immunotherapy for melanoma.

Methods

In-depth interviews were conducted with physicians (medical oncologists, surgeons and dermatologists) and nurses managing patients with resected stage III melanoma at three Australian tertiary melanoma centres between July 2019 and March 2020. Factors considered regarding adjuvant immunotherapy were explored. Recruitment continued until data saturation and thematic analysis was undertaken.

Results

Twenty-five physicians and nurses, aged 28–68 years, 60% females, including eleven (44%) medical oncologists, eight (32%) surgeons, five (20%) nurses, and one (4%) dermatologist were interviewed. Over half the sample managed five or more new resected stage III patients per month who could be eligible for adjuvant immunotherapy. Three themes about adjuvant immunotherapy recommendations emerged: [1] clinical and patient factors, [2] treatment information provision, and [3] individual physician/nurse factors. Melanoma sub-stage and an individual patient’s therapy risk/benefit profile were primary considerations. Secondary factors included uncertainty about adjuvant immunotherapy’s effectiveness and their views about treatment burden patients might consider acceptable.

Conclusions

Patients’ disease sub-stage and their treatment risk versus benefit drove the melanoma health care professionals’ adjuvant immunotherapy endorsement. Findings clarify clinician preferences and values, aiding clinical communication with patients and facilitating clinical decision-making about management options for resected stage III melanoma.

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Title: Adjuvant immunotherapy recommendations for stage III melanoma: physician and nurse interviews
Authors: Ann Livingstone
Kathy Dempsey
Martin R. Stockler
Kirsten Howard
Georgina V. Long
Matteo S. Carlino
Alexander M. Menzies
Rachael L. Morton
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Melanoma
Melanoma
Published in: BMC Cancer / Issue 1/2021
Electronic ISSN: 1471-2407
DOI: https://doi.org/10.1186/s12885-021-08752-1

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Abstract

Background

Methods

Results

Conclusions

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