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PD-1 and CTLA-4 inhibitors in combination vs. alone for the treatment of advanced melanoma: A systematic review and meta-analysis

Metastatic melanoma treatment has drastically changed during the past decade with the advent of immunotherapy. We conducted a meta-analysis, to assess PD-1 and CTLA-4 inhibitors in combination vs. alone for the treatment of advanced melanoma. METHODS: The EMBASE, Medline via PubMed, Scopus, Cochrane...

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Autores principales: He, Runzhi, Zhao, Xiaoling, Liu, Jianmin, Zhou, Yajing, Zhang, Xiaochong, Cheng, Fang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9575742/
https://www.ncbi.nlm.nih.gov/pubmed/36254050
http://dx.doi.org/10.1097/MD.0000000000030561
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author He, Runzhi
Zhao, Xiaoling
Liu, Jianmin
Zhou, Yajing
Zhang, Xiaochong
Cheng, Fang
author_facet He, Runzhi
Zhao, Xiaoling
Liu, Jianmin
Zhou, Yajing
Zhang, Xiaochong
Cheng, Fang
author_sort He, Runzhi
collection PubMed
description Metastatic melanoma treatment has drastically changed during the past decade with the advent of immunotherapy. We conducted a meta-analysis, to assess PD-1 and CTLA-4 inhibitors in combination vs. alone for the treatment of advanced melanoma. METHODS: The EMBASE, Medline via PubMed, Scopus, Cochrane Central, and Web of Science databases were searched. The records retrieved were screened for eligibility. Odds ratio (OR) was applied to compare dichotomous variables. All the results were reported with 95% confidence intervals (CI). Mantel–Haenszel method was used to estimate pooled OR and 95% confidence intervals for dichotomous data. RESULTS: We retrieved 3092 citations of which we included 3 randomized controlled trials and 2 retrospective, cohort studies. The pooled OR was 2.144 (95% CI: 1.650–2.786, I(2) = 80.38% P = .000) for overall response and 2.117 (95% CI: 1.578–2.841, I(2) = 70.17% P = .000) for the complete response (CR). Subgroup analysis in nivolumab category showed that the pooled OR was 1.766 (95% CI: 1.324–2.355, I(2) = 0.0% P = .000) for the overall response and was 1.284 (95% CI: 0.889–1.855, I(2) = 0.0% P = .182) for the CR and in the ipilimumab category the pooled OR was 5.440 (95% CI: 2.896–10.220, I(2) = 70.89% P = .001) for the overall response and was 5.169 (95% CI: 3.163–8.446, I(2) = 0.0% P = .000) for the CR. The incidence of any treatment-related adverse events was significantly higher in the combination group than that of the nivolumab monotherapy 4.044 (95% CI: 1.740–9.403, I(2) = 91.64% P = .001) or the ipilimumab monotherapy 2.465 (95% CI: 0.839–7.236, I(2) = 93.02 % P = .101). CONCLUSION: Combination therapy with ipilimumab plus nivolumab is a promising strategy in the treatment of patients with advanced melanoma with superior overall and complete responses over either monotherapies.
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spelling pubmed-95757422022-10-17 PD-1 and CTLA-4 inhibitors in combination vs. alone for the treatment of advanced melanoma: A systematic review and meta-analysis He, Runzhi Zhao, Xiaoling Liu, Jianmin Zhou, Yajing Zhang, Xiaochong Cheng, Fang Medicine (Baltimore) 4000 Metastatic melanoma treatment has drastically changed during the past decade with the advent of immunotherapy. We conducted a meta-analysis, to assess PD-1 and CTLA-4 inhibitors in combination vs. alone for the treatment of advanced melanoma. METHODS: The EMBASE, Medline via PubMed, Scopus, Cochrane Central, and Web of Science databases were searched. The records retrieved were screened for eligibility. Odds ratio (OR) was applied to compare dichotomous variables. All the results were reported with 95% confidence intervals (CI). Mantel–Haenszel method was used to estimate pooled OR and 95% confidence intervals for dichotomous data. RESULTS: We retrieved 3092 citations of which we included 3 randomized controlled trials and 2 retrospective, cohort studies. The pooled OR was 2.144 (95% CI: 1.650–2.786, I(2) = 80.38% P = .000) for overall response and 2.117 (95% CI: 1.578–2.841, I(2) = 70.17% P = .000) for the complete response (CR). Subgroup analysis in nivolumab category showed that the pooled OR was 1.766 (95% CI: 1.324–2.355, I(2) = 0.0% P = .000) for the overall response and was 1.284 (95% CI: 0.889–1.855, I(2) = 0.0% P = .182) for the CR and in the ipilimumab category the pooled OR was 5.440 (95% CI: 2.896–10.220, I(2) = 70.89% P = .001) for the overall response and was 5.169 (95% CI: 3.163–8.446, I(2) = 0.0% P = .000) for the CR. The incidence of any treatment-related adverse events was significantly higher in the combination group than that of the nivolumab monotherapy 4.044 (95% CI: 1.740–9.403, I(2) = 91.64% P = .001) or the ipilimumab monotherapy 2.465 (95% CI: 0.839–7.236, I(2) = 93.02 % P = .101). CONCLUSION: Combination therapy with ipilimumab plus nivolumab is a promising strategy in the treatment of patients with advanced melanoma with superior overall and complete responses over either monotherapies. Lippincott Williams & Wilkins 2022-10-14 /pmc/articles/PMC9575742/ /pubmed/36254050 http://dx.doi.org/10.1097/MD.0000000000030561 Text en Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by-nc/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC) (https://creativecommons.org/licenses/by-nc/4.0/) , where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal.
spellingShingle 4000
He, Runzhi
Zhao, Xiaoling
Liu, Jianmin
Zhou, Yajing
Zhang, Xiaochong
Cheng, Fang
PD-1 and CTLA-4 inhibitors in combination vs. alone for the treatment of advanced melanoma: A systematic review and meta-analysis
title PD-1 and CTLA-4 inhibitors in combination vs. alone for the treatment of advanced melanoma: A systematic review and meta-analysis
title_full PD-1 and CTLA-4 inhibitors in combination vs. alone for the treatment of advanced melanoma: A systematic review and meta-analysis
title_fullStr PD-1 and CTLA-4 inhibitors in combination vs. alone for the treatment of advanced melanoma: A systematic review and meta-analysis
title_full_unstemmed PD-1 and CTLA-4 inhibitors in combination vs. alone for the treatment of advanced melanoma: A systematic review and meta-analysis
title_short PD-1 and CTLA-4 inhibitors in combination vs. alone for the treatment of advanced melanoma: A systematic review and meta-analysis
title_sort pd-1 and ctla-4 inhibitors in combination vs. alone for the treatment of advanced melanoma: a systematic review and meta-analysis
topic 4000
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9575742/
https://www.ncbi.nlm.nih.gov/pubmed/36254050
http://dx.doi.org/10.1097/MD.0000000000030561
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