Background: In this meta-analysis, we compared the clinical efficacy and safety of ipilimumab/nivolumab combination therapy with those of ipilimumab monotherapy for stage III/IV unresectable melanoma. Materials and Methods: A search for randomized controlled trials (RCTs) reported by relevant studies conducted up to May 2021 was performed in the PubMed, Cochrane Library, Embase, CNKI, Wanfang, and VIP databases. Literature screening, data extraction, and quality evaluation were conducted independently by two researchers. The target parameters were complete response (CR), partial response (PR), objective response rate (ORR), time to progression (TTP), overall survival (OS), adverse events (AEs), and AEs in each organ system. Results: Ten articles reporting the results of three RCTs, including 790 subjects, were evaluated. In the pooled results, the CR (risk ratio [RR] = 4.48, 95% confidence interval [CI] [2.73, 7.33]), PR (RR = 2.82, 95% CI [2.09, 3.81]), and ORR (RR=3.31, 95%CI[2.60, 4.20]) were statistically different between the two treatment groups. The CR, PR, and ORR in the combination therapy group were 22.00% (90/409), 36.43% (149/409), and 58.44% (239/409), respectively, versus 4.97% (18/362), 12.98% (47/362), and 17.96% (65/362), respectively, in the monotherapy group. There were significant differences in TTP and OS between the two groups (TTP: hazard ratio [HR] = 0.41, 95% CI [0.35, 0.49]; OS: HR = 0.55, 95% CI [0.45, 0.67]). PFS and OS were longer in the combination therapy group than in the monotherapy group. The incidence of treatment-related AEs (TRAEs) and AEs leading to death (RR = 1.00, 95% CI [0.97, 1.02]; RR = 2.28, 95% CI [0.54, 9.55], respectively) was not significantly different, but the incidence of Grade 3-4 AEs and AEs leading to discontinuation was higher in the combination therapy group than in the monotherapy group (RR = 1.81, 95% CI [1.15, 2.86]); RR = 2.66, 95% CI [2.02, 3.52], respectively). Conclusions: Ipilimumab/nivolumab combination therapy was more effective than ipilimumab monotherapy for patients with stage III/IV unresectable melanoma. Although the incidence of TRAEs did not differ between the two groups, the severity of cases (Grade 3–4 AEs and AEs leading to discontinuation) was lower in the monotherapy group than in the combination therapy group. Additional high-quality studies are needed to verify the efficacy and safety of this drug combination, determine the optimal dosage, and explore additional potential drug combinations.

Background: Clear cell renal cell carcinoma (ccRCC) is one of the most common malignant tumors of the urinary system, and the prognosis of patients with advanced stage is really poor. Existing evidence suggests that inflammation and inflammation-related genes play complex roles in different tumors, but their role in ccRCC has rarely been studied as a primary research object. Methods: we used The Cancer Genome Atlas (TCGA) database to established a prognostic model risk score for ccRCC and inflammation-related genes and verified its predictive effect on the prognosis of ccRCC.Result: We screened 10 inflammatory differentially expressed genes (DEGs) with independent prognostic value for ccRCC and constructed a prognostic model risk score: (-0.0153×APLNR) + (-0.0073×BTG2) +0. 0225×CSF1+ (-0.0107×CX3CL1) +0. 1888×GABBR1+0. 1528×HAS2+0. 0088×ICAM1+0. 3952×P2RY2+ (-0.0442×SPHK1) +0. 0006×TIMP1. The survival analysis showed that ccRCC with a higher risk score implies shorter survival and worse prognosis. Then we used univariate and multivariate Cox regression analysis and Receiver Operating Characteristic (ROC) curve to confirm that the risk score has a good and stable independent prognostic value. and performed an internal validation of the risk score. Gene set enrichment analysis (GSEA) showed that high risk groups were involved in many pathways related to the occurrence and development of tumors. we also found that the expression levels of immune checkpoints including PD-1, CTLA-4, LAG3, TIGIT in ccRCC in the high risk group were significantly higher than those in the low risk group, and the ESITIMATE tool showed that the high risk group had lower tumor purity and greater heterogeneity. Conclusion: Our study initially revealed the role of inflammatory genes in ccRCC, and provided a prognostic model risk score that could predict the prognosis of ccRCC well, and may provide more information for future research and treatment of ccRCC.