PMID- 29957656
OWN - NLM
STAT- MEDLINE
DCOM- 20190422
LR  - 20190422
IS  - 1473-5636 (Electronic)
IS  - 0960-8931 (Linking)
VI  - 28
IP  - 5
DP  - 2018 Oct
TI  - Nivolumab monotherapy or in combination with ipilimumab for metastatic melanoma: 
      systematic review and meta-analysis of randomized-controlled trials.
PG  - 371-379
LID - 10.1097/CMR.0000000000000467 [doi]
AB  - Nivolumab, a completely human programmed death-1 inhibitor antibody, was first
      approved by the Food and Drug Administration for patients with advanced malignant
      melanoma resistant to other modalities of treatment. In 2015, it received
      approval as the first line of treatment for malignant melanoma. We aimed to
      synthesize evidence from published randomized-controlled trials on the safety and
      efficacy of nivolumab, either alone or in combination with ipilimumab, in the
      management of advanced unresectable melanoma. We searched the following
      electronic databases: PubMed, Scopus, Web of Science, and Cochrane Central. The
      records retrieved were screened for eligibility. Time-to-event data were pooled
      as Hazard ratio using the generic inverse variance method and dichotomous data
      were pooled as relative risk (RR) in a random-effects model. We used Review
      Manager 5.3 software for windows. Four unique randomized-controlled trials (five 
      reports) with a total of 1910 patients (nivolumab group, n=1207 and control
      group, n=703) were included. The overall effect estimate favored nivolumab plus
      ipilimumab versus ipilimumab alone in terms of the objective response rate [RR:
      3.58, 95% confidence interval (CI): 2.08-6.14], the complete response rate (RR:
      5.93, 95% CI: 2.45-14.37), the partial response rate (RR: 2.80, 95% CI:
      2.16-3.64), the stable disease rate (RR: 0.56, 95% CI: 0.41-0.76), and
      progression-free survival (hazard ratio: 0.67, 95% CI: 0.60-0.74). The pooled
      studies were homogenous. Similar results were obtained for nivolumab monotherapy 
      versus chemotherapy comparison. Nivolumab alone or combined with ipilimumab
      significantly improved the overall and complete response rates compared with
      ipilimumab alone. In addition, nivolumab resulted in longer progression-free
      survival with a comparable safety profile.
FAU - Menshawy, Amr
AU  - Menshawy A
AD  - Medical Research Education and Practice Association.
AD  - Al-Azhar Medical Students' Association.
AD  - Faculty of Medicine.
AD  - Kasr Al Ainy School of Medicine, Cairo University, Cairo.
FAU - Eltonob, Abdelrahman A
AU  - Eltonob AA
AD  - Medical Research Education and Practice Association.
AD  - Al-Azhar Medical Students' Association.
AD  - Faculty of Medicine.
AD  - Kasr Al Ainy School of Medicine, Cairo University, Cairo.
FAU - Barkat, Sarah A
AU  - Barkat SA
AD  - Medical Research Education and Practice Association.
AD  - Al-Azhar Medical Students' Association.
AD  - Faculty of Medicine.
AD  - Kasr Al Ainy School of Medicine, Cairo University, Cairo.
FAU - Ghanem, Ahmed
AU  - Ghanem A
AD  - Medical Research Education and Practice Association.
AD  - Al-Azhar Medical Students' Association.
AD  - Faculty of Medicine.
AD  - Kasr Al Ainy School of Medicine, Cairo University, Cairo.
FAU - Mniesy, Mahmoud M
AU  - Mniesy MM
AD  - Medical Research Education and Practice Association.
AD  - Al-Azhar Medical Students' Association.
AD  - Faculty of Medicine.
AD  - Kasr Al Ainy School of Medicine, Cairo University, Cairo.
FAU - Mohamed, Ishak
AU  - Mohamed I
AD  - Medical Research Education and Practice Association.
AD  - Al-Azhar Medical Students' Association.
AD  - Faculty of Medicine.
AD  - Kasr Al Ainy School of Medicine, Cairo University, Cairo.
FAU - Abdel-Maboud, Mohamed
AU  - Abdel-Maboud M
AD  - Medical Research Education and Practice Association.
AD  - Al-Azhar Medical Students' Association.
AD  - Faculty of Medicine.
AD  - Kasr Al Ainy School of Medicine, Cairo University, Cairo.
FAU - Mattar, Omar M
AU  - Mattar OM
AD  - Medical Research Education and Practice Association.
AD  - Al-Azhar Medical Students' Association.
AD  - Kasr Al Ainy School of Medicine, Cairo University, Cairo.
FAU - Elfil, Mohamed
AU  - Elfil M
AD  - Medical Research Education and Practice Association.
AD  - Faculty of Medicine, Alexandria University, Alexandria, Egypt.
FAU - Bahbah, Eshak I
AU  - Bahbah EI
AD  - Medical Research Education and Practice Association.
AD  - Damietta Faculty of Medicine, Al-Azhar University.
FAU - Elgebaly, Ahmed
AU  - Elgebaly A
AD  - Medical Research Education and Practice Association.
AD  - Al-Azhar Medical Students' Association.
AD  - Faculty of Medicine.
AD  - Kasr Al Ainy School of Medicine, Cairo University, Cairo.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
PL  - England
TA  - Melanoma Res
JT  - Melanoma research
JID - 9109623
RN  - 0 (Ipilimumab)
RN  - 31YO63LBSN (Nivolumab)
RN  - Melanoma, Cutaneous Malignant
SB  - IM
MH  - Antineoplastic Combined Chemotherapy Protocols/pharmacology
MH  - Female
MH  - Humans
MH  - Ipilimumab/administration & dosage
MH  - Male
MH  - Melanoma/*drug therapy/pathology
MH  - Nivolumab/administration & dosage/pharmacology
MH  - Randomized Controlled Trials as Topic
MH  - Skin Neoplasms/*drug therapy/pathology
EDAT- 2018/06/30 06:00
MHDA- 2019/04/23 06:00
CRDT- 2018/06/30 06:00
PHST- 2018/06/30 06:00 [pubmed]
PHST- 2019/04/23 06:00 [medline]
PHST- 2018/06/30 06:00 [entrez]
AID - 10.1097/CMR.0000000000000467 [doi]
PST - ppublish
SO  - Melanoma Res. 2018 Oct;28(5):371-379. doi: 10.1097/CMR.0000000000000467.