New emerging treatment options for metastatic melanoma: a systematic review and meta-analysis of skin cancer therapies.
Humans
Melanoma
/ drug therapy
Skin Neoplasms
/ drug therapy
Antineoplastic Combined Chemotherapy Protocols
/ therapeutic use
Randomized Controlled Trials as Topic
Immune Checkpoint Inhibitors
/ therapeutic use
Vemurafenib
/ therapeutic use
Oximes
/ therapeutic use
Progression-Free Survival
Ipilimumab
/ therapeutic use
Proto-Oncogene Proteins B-raf
/ antagonists & inhibitors
Protein Kinase Inhibitors
/ therapeutic use
Pyrimidinones
/ therapeutic use
Azetidines
/ therapeutic use
Pyridones
/ therapeutic use
Piperidines
/ therapeutic use
Imidazoles
/ therapeutic use
Chemotherapy
Cytokines
Immune checkpoint inhibitor
Immunotherapy
Melanoma
Journal
Archives of dermatological research
ISSN: 1432-069X
Titre abrégé: Arch Dermatol Res
Pays: Germany
ID NLM: 8000462
Informations de publication
Date de publication:
01 Nov 2024
01 Nov 2024
Historique:
received:
14
08
2024
accepted:
16
10
2024
revised:
04
10
2024
medline:
1
11
2024
pubmed:
1
11
2024
entrez:
1
11
2024
Statut:
epublish
Résumé
Skin cancer, notably melanoma, poses a significant global health burden, with rising incidence and mortality rates. While therapeutic advancements have improved outcomes, metastatic melanoma remains challenging to treat. This study aims to systematically review systemic treatment options for advanced melanoma, focusing on efficacy and safety in the first-line setting. Through a comprehensive search and meta-analysis of randomized controlled trials conducted from 2013 to 2023, 11 studies encompassing 2816 participants were analyzed. Treatment options included BRAF inhibitors (vemurafenib, dabrafenib), MEK inhibitors (trametinib, cobimetinib), and immune checkpoint inhibitors (ipilimumab). Combined therapy with vemurafenib, cobimetinib, and ipilimumab demonstrated superior overall survival (OS) and progression-free survival (PFS) compared to monotherapy, with a significant odds ratio (OR) of 6.95 (95% CI: 4.25-9.64, p < 0.00001) for OS and 2.49 (95% CI: 1.42-3.56, p < 0.00001) for PFS. Additionally, dabrafenib and trametinib combination therapy showed improved outcomes with favorable tolerability, including a significant reduction in adverse event (AE) risk, with an OR of 2.20 (95% CI: 1.72-2.81). Furthermore, our analysis highlighted vemurafenib-associated dermatological toxicities, emphasizing the need for effective management strategies. The study underscores the evolving treatment landscape in melanoma management, with a potential shift towards immune checkpoint inhibitors in the adjuvant setting, particularly for BRAF-mutated disease. However, limitations in meta-analysis methodologies and the need for long-term investigations into treatment implications on survival and quality of life underscore the importance of continued research.
Identifiants
pubmed: 39485529
doi: 10.1007/s00403-024-03467-2
pii: 10.1007/s00403-024-03467-2
doi:
Substances chimiques
Immune Checkpoint Inhibitors
0
Vemurafenib
207SMY3FQT
dabrafenib
QGP4HA4G1B
Oximes
0
trametinib
33E86K87QN
cobimetinib
ER29L26N1X
Ipilimumab
0
Proto-Oncogene Proteins B-raf
EC 2.7.11.1
Protein Kinase Inhibitors
0
Pyrimidinones
0
Azetidines
0
Pyridones
0
BRAF protein, human
EC 2.7.11.1
Piperidines
0
Imidazoles
0
Types de publication
Systematic Review
Meta-Analysis
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
735Informations de copyright
© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
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