PMID- 36046644
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220907
IS  - 1837-9664 (Print)
IS  - 1837-9664 (Electronic)
IS  - 1837-9664 (Linking)
VI  - 13
IP  - 10
DP  - 2022
TI  - Efficacy and Safety of Immune Checkpoint Inhibitors for Advanced Malignant 
      Melanoma: A Meta-Analysis on Monotherapy Vs Combination Therapy.
PG  - 3091-3102
LID - 10.7150/jca.72210 [doi]
AB  - Background: Immune checkpoint inhibitors (ICIs) are approved as cancer 
      immunotherapeutic agents for advanced malignant melanoma (MM) in recent years, 
      and nivolumab and ipilimumab are the most widely used ICIs either alone or in 
      combination. However, their efficacy and safety between single and combined ICIs 
      are not clear. This meta-analysis (MA) is aimed to update the efficacy and safety 
      of ICIs by comparing monotherapy and combination therapy in the treatment of 
      advanced MM. Method: We searched PubMed, Embase, EbscoHost and ClinicalTrials.gov 
      for the eligible randomized controlled trials (RCTs) which compared the efficacy 
      and safety of ICIs between a single ICI and combined ICIs. The outcomes analyzed 
      included overall survival (OS), progression-free survival (PFS), objective 
      response rate (ORR) and treatment-related adverse events (AEs). A fixed-effect or 
      random-effects model was adopted depending on the study heterogeneity. Results: A 
      total of nine RCTs were included in this MA. Regarding the efficacy, combined 
      nivolumab and ipilimumab therapy showed statistically significant prolonged OS 
      and PFS with HR 0.65, 95% CI [0.53, 0.79], p <0.0001 and HR 0.48, 95% CI [0.38, 
      0.60], p<0.0001 respectively. Combination therapy with nivolumab and ipilimumab 
      also showed statistically significant longer ORR than monotherapy; with RR 2.15, 
      95% CI [1.63, 2.84], p <0.00001. In terms of safety, the incidence of all AEs 
      which include any AEs, high-grade, haematological, gastrointestinal, 
      dermatological, pulmonary, liver and endocrine AEs were significantly lower with 
      monotherapy (either nivolumab or ipilimumab) of ICI compared to combination ICI 
      therapy with a p-value <0.00001 to 0.03. Conclusion: Efficacy of the combined 
      nivolumab and ipilimumab was better than a single ICI, especially in the 
      treatment of advanced MM. Although combination therapy showed better efficacy 
      than monotherapy, monotherapy (either nivolumab or ipilimumab) was safer than 
      combination therapy as it tended to decrease the incidence of most of the 
      treatment-related AEs.
CI  - (c) The author(s).
FAU - Pradeep, Jnaneshwari
AU  - Pradeep J
AD  - School of Medicine, International Medical University, 126, Jalan Jalil Perkasa 
      19, Bukit Jalil, 57000 Kuala Lumpur, Malaysia.
FAU - Win, Thin Thin
AU  - Win TT
AD  - Pathology Department, School of Medicine, International Medical University, 126, 
      Jalan Jalil Perkasa 19, Bukit Jalil, 57000 Kuala Lumpur, Malaysia.
FAU - Aye, Saint Nway
AU  - Aye SN
AD  - Pathology Department, School of Medicine, International Medical University, 126, 
      Jalan Jalil Perkasa 19, Bukit Jalil, 57000 Kuala Lumpur, Malaysia.
FAU - Sreeramareddy, Chandrashekhar T
AU  - Sreeramareddy CT
AD  - Community Medicine Department, School of Medicine, International Medical 
      University, 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000 Kuala Lumpur, 
      Malaysia.
LA  - eng
PT  - Journal Article
DEP - 20220808
PL  - Australia
TA  - J Cancer
JT  - Journal of Cancer
JID - 101535920
PMC - PMC9414012
OTO - NOTNLM
OT  - Immune checkpoint inhibitors
OT  - advanced malignant melanoma
OT  - combination therapy.
OT  - meta-analysis
OT  - monotherapy
OT  - systematic review
COIS- Competing Interests: The authors have declared that no competing interest exists.
EDAT- 2022/09/02 06:00
MHDA- 2022/09/02 06:01
PMCR- 2022/01/01
CRDT- 2022/09/01 02:33
PHST- 2022/02/20 00:00 [received]
PHST- 2022/07/04 00:00 [accepted]
PHST- 2022/09/01 02:33 [entrez]
PHST- 2022/09/02 06:00 [pubmed]
PHST- 2022/09/02 06:01 [medline]
PHST- 2022/01/01 00:00 [pmc-release]
AID - jcav13p3091 [pii]
AID - 10.7150/jca.72210 [doi]
PST - epublish
SO  - J Cancer. 2022 Aug 8;13(10):3091-3102. doi: 10.7150/jca.72210. eCollection 2022.