Immune checkpoint inhibitors in advanced cutaneous melanoma: a systematic review and meta-analysis of efficacy and review of characteristics.

Abstract

OBJECTIVES:

Immune checkpoint inhibitors (ICIs) are one of the most promising approaches toward advanced melanoma. Here, we aimed to perform a meta-analysis of randomized controlled trials (RCTs) to evaluate the efficacy of all studied ICIs.

METHODS:

We conducted a comprehensive search to identify the relevant publications (PROSPERO registration ID: CRD42023470649). Then we performed a meta-analysis to evaluate the efficacy of different ICIs for metastatic melanoma. We used Cochrane's tool to assess the quality of studies. The outcome measures were overall survival (OS), progression-free survival (PFS), and recurrence-free survival (RFS).

RESULTS:

Twenty reports of RCTs entered our systematic review, 18 of which were included in our data analysis. ICIs showed improved survival compared with control group (hazard ratio (HR) = 0.57; 95% CI: 0.43-0.71; P<0.001). Using a meta-regression, we found a significant relation between patients' mean age and their OS (P<0.001, R2 = 100.00%). Also, our analysis revealed greater HR for CTLA-4 inhibitors than PD-1/PD-L1 inhibitors (HR = 0.71, 95%CI: 0.63-0.79, P<0.001 vs. HR = 0.63, 95%CI: 0.46-0.79, P<0.001). The effect sizes of different types of PD-1/PD-L1 inhibitors were comparable.

CONCLUSION:

Our results suggest that ICI-based immunotherapy is associated with enhanced OS, PFS, and RFS (P < 0.001) and will assist clinicians in choosing the optimal approach toward treating metastatic melanoma.

• Authors: Sara Mahdiabadi, Sara Momtazmanesh, Amirali Karimi, Nima Rezaei
• Journal: Expert review of anticancer therapy (Expert Rev Anticancer Ther) 2023 Jul-Dec Vol. 23 Issue 12 Pg. 1281-1293 ISSN: 1744-8328 [Electronic] England
• PMID: 37908134 (Publication Type: Meta-Analysis, Systematic Review, Journal Article, Review, Research Support, Non-U.S. Gov't)

Chemical References

• Immune Checkpoint Inhibitors
• Programmed Cell Death 1 Receptor
• CTLA-4 Antigen

Topics

• Humans
• Melanoma (therapy)
• Immune Checkpoint Inhibitors (pharmacology, therapeutic use)
• Programmed Cell Death 1 Receptor
• Skin Neoplasms (drug therapy)
• CTLA-4 Antigen