PMID- 33178599
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20201113
IS  - 2234-943X (Print)
IS  - 2234-943X (Electronic)
IS  - 2234-943X (Linking)
VI  - 10
DP  - 2020
TI  - Comparative Risks of High-Grade Adverse Events Among FDA-Approved Systemic 
      Therapies in Advanced Melanoma: Systematic Review and Network Meta-Analysis.
PG  - 571135
LID - 10.3389/fonc.2020.571135 [doi]
LID - 571135
AB  - Background: Head-to-head evidence is lacking in comparative risks of high-grade 
      adverse events (AEs) among different systemic treatment options for advanced 
      melanoma. Methods: An up-to-date systematic review and network meta-analysis 
      (NMA) was performed. Randomized controlled trials (RCTs) of patients with 
      advanced melanoma were eligible if at least one intervention was the Food and 
      Drug Administration-approved targeted or immune checkpoint inhibitors. Risks of 
      high-grade AEs were estimated by random-effects Bayesian NMAs, based on relative 
      risks. Surface under the cumulative ranking probabilities was used to assess 
      relative ranking of treatments. The summary incidences were calculated. Results: 
      Twenty-five RCTs (12,925 patients) comparing 10 different systemic treatment 
      options were included. BRAF/MEK had the highest risk of overall high-grade AEs 
      (pooled incidence: 32.11%). BRAF had the highest risk of high-grade arthralgia 
      (0.39%), whereas MEK had the highest risk of high-grade hypertension (2.28%) and 
      nausea (0.37%). Cytotoxic T-lymphocyte antigen 4 (CTLA-4)/chemo had the highest 
      risk of high-grade diarrhea (1.31%), alanine aminotransferase (0.60%), and 
      aspartate aminotransferase elevation (0.59%). Programmed cell death 1 
      (PD-1)/CTLA-4 had the highest risks of high-grade pyrexia (1.14%) and rash 
      (0.94%). Using PD-1 inhibitor alone had the lowest risks of overall high-grade 
      AEs. Conclusions: Different systemic treatment options have varying high-grade 
      AEs in advanced melanoma treatment. Current evidences highlight the important 
      risks of BRAF/MEK, CTLA-4/chemo, and PD-1/CTLA-4.
CI  - Copyright (c) 2020 Huang, Xie, Fan and Du.
FAU - Huang, Ya-Fang
AU  - Huang YF
AD  - School of General Practice and Continuing Education, Capital Medical University, 
      Beijing, China.
FAU - Xie, Wen-Jie
AU  - Xie WJ
AD  - Department Clinical Research, University of Bern, Bern, Switzerland.
FAU - Fan, Hai-Yu
AU  - Fan HY
AD  - Center of Stroke, Beijing Institute for Brain Disorders, Capital Medical 
      University, Beijing, China.
FAU - Du, Juan
AU  - Du J
AD  - School of General Practice and Continuing Education, Capital Medical University, 
      Beijing, China.
LA  - eng
PT  - Systematic Review
DEP - 20201015
PL  - Switzerland
TA  - Front Oncol
JT  - Frontiers in oncology
JID - 101568867
PMC - PMC7593404
OTO - NOTNLM
OT  - advanced melanoma
OT  - high-grade adverse event
OT  - immune checkpoint inhibitor (ICI)
OT  - network meta-analysis
OT  - targeted inhibitor
EDAT- 2020/11/13 06:00
MHDA- 2020/11/13 06:01
PMCR- 2020/01/01
CRDT- 2020/11/12 05:44
PHST- 2020/06/10 00:00 [received]
PHST- 2020/09/07 00:00 [accepted]
PHST- 2020/11/12 05:44 [entrez]
PHST- 2020/11/13 06:00 [pubmed]
PHST- 2020/11/13 06:01 [medline]
PHST- 2020/01/01 00:00 [pmc-release]
AID - 10.3389/fonc.2020.571135 [doi]
PST - epublish
SO  - Front Oncol. 2020 Oct 15;10:571135. doi: 10.3389/fonc.2020.571135. eCollection 
      2020.