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Comparative Risks of High-Grade Adverse Events Among FDA-Approved Systemic Therapies in Advanced Melanoma: Systematic
Ya-Fang Huang1, Wen-Jie Xie2, Hai-Yu Fan3
1School of General Practice and Continuing Education, Capital Medical University, Beijing, China.
Frontiers in Oncology
|November 12, 2020
Summary
Systemic treatments for advanced melanoma carry different risks of severe side effects. Programmed cell death 1 (PD-1) inhibitors alone showed the lowest risk of high-grade adverse events.
Area of Science:
- Oncology
- Pharmacology
- Clinical Research
Background:
- Comparative evidence on high-grade adverse events (AEs) for advanced melanoma systemic treatments is limited.
- Understanding these risks is crucial for optimizing patient care and treatment selection.
Approach:
- A systematic review and network meta-analysis (NMA) of randomized controlled trials (RCTs) were conducted.
- The analysis included 25 RCTs with 12,925 patients comparing 10 systemic treatment options.
- Bayesian NMAs estimated risks of high-grade AEs, with treatment rankings assessed by cumulative probabilities.
Key Points:
- BRAF/MEK inhibitors showed the highest overall high-grade AE incidence (32.11%).
- Specific high-grade AEs were linked to certain treatments: BRAF (arthralgia), MEK (hypertension, nausea), CTLA-4/chemo (diarrhea, liver enzyme elevation), and PD-1/CTLA-4 (pyrexia, rash).
- Monotherapy with PD-1 inhibitors presented the lowest risk of overall high-grade AEs.
Conclusions:
- Systemic treatments for advanced melanoma exhibit distinct high-grade AE profiles.
- Combinations like BRAF/MEK, CTLA-4/chemo, and PD-1/CTLA-4 are associated with significant AE risks that warrant careful consideration.
Keywords:
advanced melanomahigh-grade adverse eventimmune checkpoint inhibitor (ICI)network meta-analysistargeted inhibitorMore Related Videos
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