{"title":"Efficacy and safety of nivolumab plus ipilimumab versus nivolumab alone in patients with advanced melanoma: a systematic review and meta-analysis.","authors":"Shuting Cui, Xiaozhe Sun, Junxi Gao","doi":"10.1080/14737140.2024.2336106","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Annual melanoma incidence in the US is escalating.</p><p><strong>Objective: </strong>Comprehensive evaluation of nivolumab alone or with ipilimumab for advanced melanoma treatment.</p><p><strong>Research design and methods: </strong>A systematic search was conducted across PubMed, Embase, Web of Science, and Cochrane databases, extending until August 2023. A range of outcomes were evaluated, encompassing overall survival (OS), recurrence-free survival (RFS), progression-free survival (PFS), disease-free survival (DFS), adverse events (both any and serious), complete response rate, mortality rate, and recurrence rate in patients with advanced melanoma.</p><p><strong>Results: </strong>This analysis was conducted on seven relevant studies, involving 2,885 patients. The baseline characteristics of both groups were found to be comparable across all outcomes, with the exception of tumor size. The pooled analysis did not reveal any significant disparities, except for PFS, where the nivolumab-ipilimumab treatment group demonstrated a significantly longer PFS compared to the nivolumab group. However, there was a notable discrepancy in any adverse events (Odds Ratio (OR): 2.69; 95% Confidence Interval (CI): 1.96, 3.69; <i>p</i> < 0.00001) and serious adverse events (OR: 3.59; 95% CI: 2.88, 4.49, <i>p</i> < 0.00001) between the two groups, suggesting that the safety profile of nivolumab combined with ipilimumab was inferior.</p><p><strong>Conclusions: </strong>Given diversity and potential biases, oncologists should base immunotherapy decisions on professional expertise and patient characteristics.</p><p><strong>Registration: </strong>PROSPERO registration number: CRD42023453484.</p>","PeriodicalId":12099,"journal":{"name":"Expert Review of Anticancer Therapy","volume":null,"pages":null},"PeriodicalIF":2.9000,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Expert Review of Anticancer Therapy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/14737140.2024.2336106","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/3/29 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Annual melanoma incidence in the US is escalating.
Objective: Comprehensive evaluation of nivolumab alone or with ipilimumab for advanced melanoma treatment.
Research design and methods: A systematic search was conducted across PubMed, Embase, Web of Science, and Cochrane databases, extending until August 2023. A range of outcomes were evaluated, encompassing overall survival (OS), recurrence-free survival (RFS), progression-free survival (PFS), disease-free survival (DFS), adverse events (both any and serious), complete response rate, mortality rate, and recurrence rate in patients with advanced melanoma.
Results: This analysis was conducted on seven relevant studies, involving 2,885 patients. The baseline characteristics of both groups were found to be comparable across all outcomes, with the exception of tumor size. The pooled analysis did not reveal any significant disparities, except for PFS, where the nivolumab-ipilimumab treatment group demonstrated a significantly longer PFS compared to the nivolumab group. However, there was a notable discrepancy in any adverse events (Odds Ratio (OR): 2.69; 95% Confidence Interval (CI): 1.96, 3.69; p < 0.00001) and serious adverse events (OR: 3.59; 95% CI: 2.88, 4.49, p < 0.00001) between the two groups, suggesting that the safety profile of nivolumab combined with ipilimumab was inferior.
Conclusions: Given diversity and potential biases, oncologists should base immunotherapy decisions on professional expertise and patient characteristics.
期刊介绍:
Expert Review of Anticancer Therapy (ISSN 1473-7140) provides expert appraisal and commentary on the major trends in cancer care and highlights the performance of new therapeutic and diagnostic approaches.
Coverage includes tumor management, novel medicines, anticancer agents and chemotherapy, biological therapy, cancer vaccines, therapeutic indications, biomarkers and diagnostics, and treatment guidelines. All articles are subject to rigorous peer-review, and the journal makes an essential contribution to decision-making in cancer care.
Comprehensive coverage in each review is complemented by the unique Expert Review format and includes the following sections:
Expert Opinion - a personal view of the data presented in the article, a discussion on the developments that are likely to be important in the future, and the avenues of research likely to become exciting as further studies yield more detailed results
Article Highlights – an executive summary of the author’s most critical points.