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We conducted a retrospective observational cohort study of 183 patients with metastatic melanoma who died following immunotherapy treatment to investigate sites of metastases at death, settings of death, and mechanisms of death. The median time from metastatic diagnosis to death was 16.1\u2009months (range 0.3\u2013135.1\u2009months). Most patients experienced hospitalization within 3\u2009months before death (80.3%), with 31.7% dying while hospitalized, 31.2% while in inpatient hospice, and 29.4% while in home hospice. The most common sites of metastases at death were distant lymph nodes (62.8%), lung (57.9%), liver (50.8%), brain (38.8%), and bone (37.7%). The most common causes of death were progressive failure to thrive (57.5%), respiratory failure (22.4%), and infection (21.8%); the vast majority (87.9%) of patients died from melanoma\u2010specific causes. Overall, 10.9% of patients in our cohort had survival &gt;5\u2009years after metastatic diagnosis, and 76.2% of long\u2010term survivors died due to melanoma. This study describes factors associated with melanoma mortality, highlighting an ongoing need for therapeutic advancements.<\/jats:p>","DOI":"10.1111\/pcmr.13188","type":"journal-article","created":{"date-parts":[[2024,7,29]],"date-time":"2024-07-29T06:49:38Z","timestamp":1722235778000},"page":"847-853","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Causes of death and patterns of metastatic disease at the end of life for patients with advanced melanoma in the immunotherapy era"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9106-9342","authenticated-orcid":false,"given":"Daniel Y.","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Internal Medicine (Oncology) Smilow Cancer Center at Yale New Haven Hospital  New Haven Connecticut 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