Comparative efficacy and safety of immune checkpoint inhibitor-related therapies for advanced melanoma: a Bayesian

Xin Li1, Junpeng Wang2, Yun Yao1

  • 1Department of Molecular Biology, College of Basic Medical Sciences, Norman Bethune Health Science Center, Jilin University, Changchun 130021, China.

Oncotarget
|November 16, 2017
PubMed
Abstract

Insights

Nivolumab, pembrolizumab, and ipilimumab plus sargramostim offer the best balance of benefits and safety for advanced melanoma patients. While ipilimumab plus nivolumab improves progression-free survival, it has higher toxicity.

Area of Science:

  • Oncology
  • Immunotherapy
  • Melanoma Treatment

Background:

  • Advanced melanoma presents a significant therapeutic challenge.
  • Immune checkpoint inhibitors (ICIs) have revolutionized melanoma treatment.
  • Comparing the efficacy and safety of various ICI-related therapies is crucial.

Purpose of the Study:

  • To compare and rank the effectiveness of nine immune checkpoint inhibitor-related therapies for advanced melanoma.
  • To evaluate the balance between therapeutic benefits and patient acceptability for each treatment strategy.

Main Methods:

  • Systematic literature search of PubMed, Cochrane, Web of Science, and ClinicalTrials.gov for randomized controlled trials.
  • Bayesian network meta-analysis framework to compare treatment efficacy and safety.
  • Inclusion of 12 trials with 5413 patients in the analysis.

Main Results:

  • Nivolumab, pembrolizumab, and ipilimumab plus sargramostim demonstrated a favorable benefit-risk profile.
  • Ipilimumab plus nivolumab showed superior progression-free survival (PFS) but higher toxicity.
  • Nivolumab and pembrolizumab exhibited the best safety profiles with significantly fewer adverse events.

Conclusions:

  • Nivolumab, pembrolizumab, and ipilimumab plus sargramostim are potential optimal treatments for advanced melanoma.
  • The choice of therapy should consider the balance between efficacy (PFS, OS) and tolerability.
  • Ipilimumab plus nivolumab is highly effective for PFS but carries a significant toxicity burden.

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