Pharmacological interventions for melanoma: Comparative analysis using bayesian meta-analysis
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Yang Yang1,2,*, Jiaomiao Pei1,*, Guozhen Gao3, Zheng Yang4, Shuzhong Guo1, Bo Yue5, Jianhua Qiu5
1Department of Plastic and Reconstructive Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an, 710032, China
2Medical Insurance and New Rural Cooperative Medical Insurance Administration Center, The 252nd Hospital of PLA, Baoding, 071000, China
3Department of Burn and Plastic Surgery, The 253rd Hospital of PLA, Hohhot, 010051, China
4The First Brigade of Fourth Military Medical University, Xi’an, 710032, China
5Department of Otolaryngology-Head and Neck Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an, 710032, China
*These authors have contributed equally to this work
Bo Yue, email: [email protected]
Jianhua Qiu, email: [email protected]
Keywords: melanoma, chemotherapy, ipilimumab, tremelimumab, nivolumab
Received: June 20, 2016 Accepted: September 21, 2016 Published: October 13, 2016
We conducted a network meta-analysis in order to compare different strategies for managing melanoma patients. Electronic databases were searched for eligible randomized trials that compared different strategies in efficacy and tolerability. Five interventions were associated with a significant improvement in PFS over chemotherapy (all HR < 1): Ipilimumab, Tremelimumab, Nivolumab, Pembrolizumab 2 mg/kg and Ipilimumab + Nivolumab. Three interventions exhibited significantly improved OS results over chemotherapy (all HR < 1): Ipilimumab, Nivolumab and Ipilimumab + Chemotherapy. Four interventions were superior to chemotherapy in CR and PR (all OR > 1): Nivolumab, Pembrolizumab 10 mg/kg, Pembrolizumab 2 mg/kg and Ipilimumab + Nivolumab. However, the other seven interventions were associated with an increased risk of pruritus compared to chemotherapy (all OR > 1). Ipilimumab, Tremelimumab, Ipilimumab + Nivolumab and Ipilimumab + Chemotherapy might result in a higher risk of diarrhea compared to chemotherapy (all OR > 1). Immune checkpoint therapy or combined interventions might be more effective than chemotherapy for managing melanoma patients. However, chemotherapy appears to be more tolerable than these combined strategies with respect to adverse events.
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