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Salvage Therapy for Relapsed Malignant Pleural Mesothelioma: A Systematic Review and Network Meta-Analysis.

Authors :
Tsai YC
Chen HL
Lee TH
Chang HM
Wu KL
Chuang CH
Chang YC
Tu YK
Hung JY
Yang CJ
Chong IW
Source :
Cancers [Cancers (Basel)] 2021 Dec 30; Vol. 14 (1). Date of Electronic Publication: 2021 Dec 30.
Publication Year :
2021

Abstract

Patients with malignant pleural mesothelioma (MPM) have very poor prognoses, and pemetrexed plus platinum is the standard first-line therapy. However, the second-line therapy for relapsed MPM remains controversial. A comprehensive search was performed to identify randomized controlled trials (RCTs) evaluating various second-line regimens in patients with relapsed MPM. Indirect comparisons of overall survival (OS) and progression-free survival (PFS) were performed using network meta-analysis. Surface under the cumulative ranking curve (SUCRA) values were used to rank the included treatments according to each outcome. Nivolumab alone or nivolumab plus ipilimumab provided significantly longer OS than placebo (hazard ratio (HR): 0.72, 95% confidence interval (CI): 0.55-0.94 for nivolumab alone; HR: 0.54, 95% CI: 0.31-0.92 for nivolumab plus ipilimumab). The best SUCRA ranking for OS was identified for nivolumab plus ipilimumab (SUCRA: 90.8%). Tremelimumab, vorinostat, nivolumab alone, chemotherapy (CTX), asparagine-glycine-arginine-human tumor necrosis factor plus CTX, and nivolumab plus ipilimumab all produced noticeable PFS benefits compared with placebo. Nivolumab plus ipilimumab had the best PFS ranking (SUCRA: 92.3%). Second-line treatment with nivolumab plus ipilimumab provided the OS and PFS outcomes for patients with relapsed MPM.

Details

Language :
English
ISSN :
2072-6694
Volume :
14
Issue :
1
Database :
MEDLINE
Journal :
Cancers
Publication Type :
Academic Journal
Accession number :
35008346
Full Text :
https://doi.org/10.3390/cancers14010182