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Comparative efficacy and safety of adjuvant nivolumab versus other treatments in adults with resected melanoma: a systematic literature review and network meta-analysis
- Source :
- BMC Cancer, Vol 21, Iss 1, Pp 1-11 (2021), BMC Cancer
- Publication Year :
- 2021
- Publisher :
- BMC, 2021.
-
Abstract
- Background Immune checkpoint inhibitors and targeted therapies are approved for adjuvant treatment of patients with resected melanoma; however, they have not been compared in randomized controlled trials (RCTs). We compared the efficacy and safety of adjuvant nivolumab with other approved treatments using available evidence from RCTs in a Bayesian network meta-analysis (NMA). Methods A systematic literature review was conducted through May 2019 to identify relevant RCTs evaluating approved adjuvant treatments. Outcomes of interest included recurrence-free survival (RFS)/disease-free survival (DFS), distant metastasis-free survival (DMFS), all-cause grade 3/4 adverse events (AEs), discontinuations, and discontinuations due to AEs. Time-to-event outcomes (RFS/DFS and DMFS) were analyzed both assuming that hazard ratios (HRs) are constant over time and that they vary. Results Of 26 identified RCTs, 19 were included in the NMA following a feasibility assessment. Based on HRs for RFS/DFS, the risk of recurrence with nivolumab was similar to that of pembrolizumab and lower than that of ipilimumab 3 mg/kg, ipilimumab 10 mg/kg, or interferon. Risk of recurrence with nivolumab was similar to that of dabrafenib plus trametinib at 12 months, however, was lower beyond 12 months (HR [95% credible interval] at 24 months, 0.46 [0.27–0.78]; at 36 months, 0.28 [0.14–0.59]). Based on HRs for DMFS, the risk of developing distant metastases was lower with nivolumab than with ipilimumab 10 mg/kg or interferon and was similar to dabrafenib plus trametinib. Conclusion Adjuvant therapy with nivolumab provides an effective treatment option with a promising risk–benefit profile.
- Subjects :
- Oncology
Cancer Research
medicine.medical_specialty
Efficacy
Pyridones
Ipilimumab
Pyrimidinones
Pembrolizumab
Antibodies, Monoclonal, Humanized
lcsh:RC254-282
Disease-Free Survival
law.invention
03 medical and health sciences
0302 clinical medicine
Randomized controlled trial
law
Internal medicine
Antineoplastic Combined Chemotherapy Protocols
Oximes
Genetics
medicine
Adjuvant therapy
Humans
030212 general & internal medicine
Network meta-analysis
Melanoma
Trametinib
business.industry
Hazard ratio
Systematic literature review
Imidazoles
Bayes Theorem
Dabrafenib
Adjuvant treatment
lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Nivolumab
030220 oncology & carcinogenesis
Patient Safety
Safety
business
Research Article
medicine.drug
Subjects
Details
- Language :
- English
- ISSN :
- 14712407
- Volume :
- 21
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- BMC Cancer
- Accession number :
- edsair.doi.dedup.....bc98a3a5f691ad489a874fb3c12695ab