Immune checkpoint inhibitors in adjuvant setting after radical resection of melanoma: a meta-analysis of the pivotal trials.
Melissa BersanelliFausto PetrelliSebastiano ButiIgnazio StanganelliPublished in: Human vaccines & immunotherapeutics (2021)
Beyond the overall relapse-free survival (RFS) advantage demonstrated in randomized trials (RCT) of adjuvant anti-PD-1 immunotherapy in radically resected stage III-IV melanoma, key issues about subgroups of interest have been raised in recent years, with non-conclusive results when considering single studies. In the present meta analysis, we pooled all RCT data in this setting, analyzing, overall, 3043 patients. The RFS benefit of adjuvant immunotherapy over the comparator (placebo or anti-CTLA-4) was strongly confirmed in the pooled analysis, and it was statistically significant in most subgroups, excluding patients with stage IIIA and stage IV M1c melanoma. Nevertheless, the relative benefit was not statistically significantly different when considering their IIIB-IIIC and M1a-M1b counterparts. Future trials in this setting should consider subgroups of interest for tailoring the adjuvant strategy in terms of duration and drug combination in light of literature data.
Keyphrases
- free survival
- early stage
- systematic review
- end stage renal disease
- electronic health record
- prognostic factors
- skin cancer
- chronic kidney disease
- big data
- newly diagnosed
- case control
- peritoneal dialysis
- randomized controlled trial
- machine learning
- current status
- data analysis
- study protocol
- artificial intelligence
- open label