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Updated: Jan 28, 2026
Analysis of Lymph Node Volume by Ultra-High-Frequency Ultrasound Imaging in the Braf/Pten Genetically Engineered Mouse Model of Melanoma
Published on: September 8, 2021
Network meta-analysis of therapies for previously untreated advanced BRAF-mutated melanoma
Michael J Zoratti1, Tahira Devji1, Oren Levine2
1Department of Health Research Methods, Evidence, and Impact, McMaster University, Room 2C16, 1280 Main Street West, Hamilton, Ontario L8S 4K1, Canada.
Background:
The spectrum of treatment options for patients with metastatic BRAF-mutated melanoma is broad, spanning multiple treatment classes. However, there is a lack of head-to-head evidence comparing targeted and immunotherapies. The purpose of this study is to conduct a network meta-analysis (NMA) in previously untreated, BRAF-mutated melanoma patients and estimate the relative efficacy of systemic therapies for this patient population at the treatment level.
Methods:
The literature review included searches of MEDLINE, EMBASE, and the Cochrane Central Registry of Controlled Trials (CENTRAL) to November 2018. Randomized controlled trials of previously untreated patients with advanced melanoma were eligible if at least one intervention was either a targeted or immune therapy. Relative treatment effects were estimated by fixed effect Bayesian NMAs on progression-free survival (PFS) and overall survival (OS), based on the hazard ratio.
Results:
Combination dabrafenib with trametinib (HR 0.22 [95% CrI 0.17, 0.28] vs dacarbazine) and combination vemurafenib with cobimetinib (HR 0.22 [95% CrI 0.17, 0.29] vs dacarbazine) were likely to rank as the most favorable treatment options for PFS, while combination nivolumab with ipilimumab was likely to be the most efficacious in terms of OS (HR 0.33 [0.24, 0.47] vs dacarbazine).
Conclusions And Relevance:
The findings highlight the efficacy of combination PD-1 with CTLA-4 inhibitors and combination BRAF with MEK inhibitors in the treatment of advanced melanoma. However, as few trials informed each treatment comparison, research is needed to further refine our understanding of this complex and rapidly evolving treatment landscape.
Insights
For advanced BRAF-mutated melanoma, combination targeted therapies offer superior progression-free survival, while combined immunotherapy shows promise for overall survival. Further research is needed in this evolving field.
Area of Science:
- Oncology
- Medical Research
- Clinical Trials
Background:
- Metastatic BRAF-mutated melanoma has diverse treatment options.
- Head-to-head data comparing targeted therapies and immunotherapies is limited.
- Understanding relative efficacy is crucial for treatment selection.
Purpose of the Study:
- To conduct a network meta-analysis (NMA) for previously untreated, BRAF-mutated melanoma.
- To estimate the relative efficacy of systemic therapies at the treatment level.
Main Methods:
- Searched MEDLINE, EMBASE, and CENTRAL up to November 2018.
- Included randomized controlled trials of advanced melanoma with targeted or immune therapy.
- Estimated relative treatment effects using Bayesian NMAs for progression-free survival (PFS) and overall survival (OS).
Main Results:
- Combination dabrafenib/trametinib and vemurafenib/cobimetinib showed superior PFS compared to dacarbazine.
- Combination nivolumab/ipilimumab demonstrated the highest efficacy for OS versus dacarbazine.
Conclusions:
- Combination PD-1/CTLA-4 inhibitors and BRAF/MEK inhibitors are effective in advanced melanoma.
- Limited trial data for specific comparisons necessitates further research.
- Refining understanding of this complex treatment landscape is ongoing.
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