A Network Meta-Analysis of Short and Long-Term Efficacy of Targeted Therapy With Single or Double-Drug Regimens in the Treatment of Stage III/IV Malignant Melanoma Based on 16 Randomized Controlled Trials

J Cell Biochem. 2018 Jan;119(1):640-649. doi: 10.1002/jcb.26225. Epub 2017 Jul 31.

Abstract

For the treatment of stage III/IV malignant melanoma (MM), a network meta-analysis (NMA) was conducted to compare the short and long-term efficacy of targeted therapy with single or double-drug regimens. All conducted randomized controlled trials (RCTs) searched from PubMed and Cochrane Library were included in the study for direct and indirect comparison for MM. The odds ratio (OR) and surface under the cumulative ranking curves (SUCRA) value of the targeted therapy with single or double-drug regimens for treatment of stage III/IV MM were also analyzed. To group the treatments according to their similarity with regards to both outcomes, cluster analyses were performed. Ultimately, 16 RCTs were incorporated for this NMA. The NMA revealed that the overall response rate (ORR) values of single-drug regimens (Vemurafenib [Vem], Dabrafenib [Dab], and Nivolumab [Niv]) were higher than those of Dacarbazine (Dac). Also the ORR values of double-drug regimens (Dab + Trametinib [Dab + Tra], Niv + Ipilimumab [Niv + Ipi], and Vem + Cobimetinib [Vem + Cob]) were moderately higher than those of Dac. The results of the SUCRA showed that short-term efficacy of single-drug regimens (Vem and Dab) were better, while the short-term efficacy of double-drug regimens (Dab + Tra and Vem + Cob) were relatively better. It was determined that Vem, Dab, and Niv might be the best choice in evaluating the treatment of stage III/IV MM among different single-drug targeted therapy regimens, while Dab + Tra, Niv + Ipi, and Vem + Cob might have better short-term efficacy among different double-drug targeted therapy regimens. J. Cell. Biochem. 119: 640-649, 2018. © 2017 Wiley Periodicals, Inc.

Keywords: DOUBLE-DRUG; LONG-TERM EFFICACY; MALIGNANT MELANOMA; NETWORK META-ANALYSIS; OVERALL RESPONSE RATE; RANDOMIZED CONTROLLED TRIALS; SHORT-TERM EFFICACY; SINGLE-DRUG; SURFACE UNDER THE CUMULATIVE RANKING CURVES; TARGETED THERAPY.

Publication types

  • Comparative Study

MeSH terms

  • Antibodies, Monoclonal / therapeutic use
  • Antineoplastic Agents / therapeutic use*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Azetidines / therapeutic use
  • Dacarbazine / therapeutic use
  • Humans
  • Imidazoles / therapeutic use
  • Indoles / therapeutic use
  • Ipilimumab / therapeutic use
  • Melanoma / drug therapy*
  • Melanoma / pathology*
  • Molecular Targeted Therapy
  • Neoplasm Staging
  • Network Meta-Analysis
  • Nivolumab
  • Odds Ratio
  • Oximes / therapeutic use
  • Piperidines / therapeutic use
  • Pyridones / therapeutic use
  • Pyrimidinones / therapeutic use
  • Randomized Controlled Trials as Topic
  • Sulfonamides / therapeutic use
  • Survival Analysis
  • Treatment Outcome
  • Vemurafenib

Substances

  • Antibodies, Monoclonal
  • Antineoplastic Agents
  • Azetidines
  • Imidazoles
  • Indoles
  • Ipilimumab
  • Oximes
  • Piperidines
  • Pyridones
  • Pyrimidinones
  • Sulfonamides
  • Vemurafenib
  • Nivolumab
  • trametinib
  • Dacarbazine
  • cobimetinib
  • dabrafenib