3 years ago

Impact of clinicopathological characteristics on survival in patients treated with immune checkpoint inhibitors for metastatic melanoma

Hong Zhao, Jiaxin Zhao, Bin Zhao


Immune checkpoint inhibitors (ICIs) have unprecedented effects on the treatment of metastatic melanoma. However, little is known about the prognostic values of various clinicopathological characteristics. Here, PubMed, Embase and Cochrane database were searched from inception to April 2018 for random controlled trials (RCTs) that compared ICIs with controls. The hazard ratios (HRs) for overall survival (OS) according to gender, age, Eastern Cooperative Oncology Group (ECOG) performance status (PS), lactate dehydrogenase (LDH) level, and metastasis stage were extracted. Four phase III RCTs involving 1598 patients with metastatic melanoma were included in this study. Compared with conventional agents, ICIs were associated with prolonged OS (HR, 0.67; 95% CI, 0.50‐0.88; p=0.005). The pooled OS HR was 0.60 (95% CI, 0.42‐0.84; p=0.003) in men; 0.84 (95% CI, 0.69‐1.01; p=0.07) in women. The difference in efficacy between men and women was significant (pinteraction=0.03). The OS HR was 0.59 (95% CI, 0.41‐0.83; p=0.003) in patients >65 years old; 0.74 (95% CI, 0.55‐1.01; p=0.054) in patients <65 years old. The OS HR was 0.75 (95% CI, 0.60‐0.94; p=0.01) in patients with ECOG PS=1; 0.64 (95% CI, 0.38‐1.06; p=0.08) in patients with ECOG PS=0. Additionally, the long‐term benefits were independent of metastasis stage and LDH level. In summary, although immunotherapy significantly prolongs overall survival in metastatic melanoma, the long‐term benefits in women, younger patients (<65 years old) and patients with ECOG PS=0 were marginal. These results may assist in treatment decision‐making, design and interpretation of clinical trials, and economic analyses.

This article is protected by copyright. All rights reserved.

You might also like
Discover & Discuss Important Research

Keeping up-to-date with research can feel impossible, with papers being published faster than you'll ever be able to read them. That's where Researcher comes in: we're simplifying discovery and making important discussions happen. With over 19,000 sources, including peer-reviewed journals, preprints, blogs, universities, podcasts and Live events across 10 research areas, you'll never miss what's important to you. It's like social media, but better. Oh, and we should mention - it's free.

  • Download from Google Play
  • Download from App Store
  • Download from AppInChina

Researcher displays publicly available abstracts and doesn’t host any full article content. If the content is open access, we will direct clicks from the abstracts to the publisher website and display the PDF copy on our platform. Clicks to view the full text will be directed to the publisher website, where only users with subscriptions or access through their institution are able to view the full article.