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An update on access to novel treatment for metastatic melanoma in Europe - A 2024 survey of the European melanoma registry and the European association of dermato-oncology

Kandolf, L.
Ascierto, P. A.
Bastholt, L.
Gavrilova, I.
Haanen, J.
Hauschild, A.
Herceg, D.
Hoeller, C.
Jalovcic Suljevic, A.
Kessels, J. I.
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Abstract
Advances in cancer treatments have significantly improved their effectiveness, yet access to first-line therapies remains limited. A 2017 survey revealed that over 25 % of metastatic melanoma patients in Europe lacked access to recommended therapies. To address this, the European Association of Dermato-Oncology and the European Melanoma Registry conducted a follow-up study on the registration and reimbursement of first-line treatments.A web-based survey using LimeSurvey was distributed to melanoma experts across 27 European countries from February to April 2022 and updated from February to April 2024. The questionnaire covered the percentage of patients receiving recommended treatments, as well as treatment authorization and reimbursement dates for systemic and adjuvant therapies.There has been significant improvement in the registration and reimbursement of BRAFi/MEKi, anti-PD1, and anti-PD1/anti-CTLA4 therapies, increasing from 48 %, 63 %, and 37 % in 2017 to 96 %, 96 %, and 78 % in 2024, respectively. Despite these gains, restrictions persist. Anti-PD1/anti-CTLA4 combination immunotherapy is still not available without restrictions in 48 % of the surveyed countries. The nivolumab/relatlimab combination is licensed only for PDL-1-negative melanoma and reimbursed in seven countries of Europe. Tebentafusp is reimbursed in 15 countries and talimogene laherpervec in 5. In 2024, adjuvant treatments for stage III melanoma are reimbursed in 22 countries for dabrafenib/trametinib and 24 of 27 for anti-PD1 antibodies. Pembrolizumab and nivolumab are reimbursed in 15 and 8 countries, respectively, for stage IIB/IIC disease.While there have been improvements in the reimbursement of metastatic melanoma treatments in Europe, challenges and discrepancies remain. Further efforts at European and global levels are needed to harmonize and enhance access to cancer medicines.
Affiliation
Faculty of Medicine, Military Medical Academy, Belgrade, Serbia. Electronic address: lidijakandolf@gmail.com. Melanoma. Cancer Immunotherapy and Development Therapeutics Unit, Istituto Nazionale Tumori IRCCS Fondazione 'G. Pascale', Napoli, Italy. Department of Oncology, Odense University Hospital, Odense, Denmark. Department of Oncodermatology, National Cancer Center, Sofia, Bulgaria. The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, Netherlands. Department of Dermatology, University Hospital Schleswig-Holstein - Campus Kiel, Kiel, Germany. Department of Oncology, University Hospital Centre Zagreb, Zagreb, Croatia. Department of Dermatology, Medical University of Vienna, Vienna, Austria. Department of Oncology, University Clinical Center of Sarajevo, Sarajevo, Bosnia and Herzegovina. Department of Dermatology and Medical Oncology, Universitair Ziekenhuis Brussel, Brussels, Belgium. Department of Oncology, General University Hospital Prague, Prague, Czech Republic. Oncodermatology center of the medical chain 'Dobrobut', Kiev, Ukraine. Department of Dermatology, Aristotle University of Thessaloniki, Thessaloniki, Greece. Department of Oncology, Christie NHS Foundation Trust, University of Manchester, United Kingdom. Department of Dermatology, University Hospital Zurich, Zurich, Switzerland. Department of Oncology, Hospital General Universitario Gregorio Marañón, Madrid, Spain. Department of Oncology, Faculty of Medicine, University of Constanta, Romania. Department of Dermatology, Elbe Klinikum Buxtehude, Buxtehude, Germany. Faculty of Medicine, Centre of Dermatovenereology, Clinic of Infectious Diseases and Dermatovenereology, Vilnius University, Vilnius, Lithuania. Institute of Oncology Ljubljana, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia. Department of Oncotherapy, University of Szeged, Szeged, Hungary. North Estonia Medical Centre Interdisciplinary Cancer Centre, Talinn, Estonia. Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland. Department of General and Oncologic Dermatology, Ambroise Paré hospital, APHP, & EA 4340 'Biomarkers in cancerology and haematooncology', UVSQ, Université Paris-Saclay, Boulogne-Billancourt, 92104, France. FSBI 'N.N. Blokhin National Medical Research Center of Oncology', Moscow, Russia. Department of Medical Oncology, University of Brussels, Belgium. University Clinic of Radiotherapy and Oncology, Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, Macedonia. Oncology Clinic, Clinical Centre of Montenegro, Podgorica, Montenegro. Clinics of Dermatology, Faculty of Medicine of Coimbra University, Coimbra, Portugal. University Skin Cancer Center Kiel, University Hospital of Schleswig-Holstein, Kiel, Germany. University Hospital Tübingen, Tübingen, Germany.
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2025
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Kandolf L, Ascierto PA, Bastholt L, Gavrilova I, Haanen J, Hauschild A, et al. An update on access to novel treatment for metastatic melanoma in Europe - A 2024 survey of the European melanoma registry and the European association of dermato-oncology. European journal of cancer (Oxford, England : 1990). 2025 Feb 5;216:115124. PubMed PMID: 39721295. Epub 2024/12/26. eng.
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