Patient-reported quality of life in adolescents and young adults with melanoma

Purpose: Adolescents and young adults (AYAs, diagnosed between 15–39 years) with melanoma experience unique challenges distinct from those experienced by children and older adults. This study aims to evaluate health-related quality of life (HRQOL) in AYAs with melanoma and identify factors correlated with HRQOL outcomes. Methods: A cohort of 45 AYAs with melanoma was surveyed to assess HRQOL across multiple domains, including physical, emotional, and social functioning. Data were analyzed to compare HRQOL in patients undergoing active treatment versus those in post-treatment survivorship and between those treated with ICBs and those never treated with ICBs. Results: AYAs reported impaired HRQOL across all domains. Over 60% reported mild to severe levels of anxiety, with 68% of females affected. More patients on active treatment, compared with those in post-treatment survivorship, reported impairment in physical function (64% vs 20%, p < 0.001), depression (52% vs 16%, p = 0.028), fatigue (60% vs 21%, p = 0.005), sleep disturbance (48% vs 21%, p = 0.013), pain interference (68% vs 16%, p < 0.001), and impaired social roles (32% vs 5%, p = 0.004). Patients receiving ICBs, compared with those never treated with ICBs, reported worse anxiety (76% vs 37%, p = 0.042) and fatigue (56% vs 26%, p = 0.036) and greater sleep disturbance (52% vs 16%, p = 0.002), and impaired social roles (28% vs 11%, p = 0.004). Conclusion: AYAs with melanoma experience elevated levels of distress and impaired HRQOL, particularly during active treatment and with ICB use. Interventions targeting HRQOL are essential to address the unique needs of this vulnerable population.