1330P - Adjuvant therapies for stage III melanoma: Benchmarks for bringing clinical trials to clinical practice

New efficacious systemic therapies for advanced melanoma have been practice changing. More recently these therapies have been tested in the adjuvant setting for stage III disease with positive results. With recent FDA and EMA approvals for stage III disease we wished to evaluate current uptake of adjuvant therapies for stage III melanoma. Such benchmark data will be important in testing our ability to integrate clinical trial data into clinical practice. We identified 34,376 stage III patients from the National Cancer Database (NCDB) diagnosed 2004-2015 with known extent of LN surgery and no prior invasive cancer. Use of adjuvant chemotherapy (including targeted therapy), immunotherapy and radiation therapy was assessed. Cochran-Armitage trend tests were used to test for changes in proportions over time overall and stratified by substage. Of the 34,376 patients, median age 57 years, 21,093 (61.4%) were male and 33,300 Caucasian (97.7%). The median (mean) number of positive nodes was 1 (2.1), IQR 1-2, range 1-81. Overall, 9,180 patients (27.4%) received adjuvant immunotherapy, 2,467 (7.5%) adjuvant chemotherapy and 3,088 (9.1%) adjuvant radiation. Any adjuvant therapy use declined over time from 41.9% in 2004 to 35.8% in 2015 (p