Overall survival (OS) in the management of pretreated patients with unresectable stage III/IV melanoma: A systematic literature review and meta-analysis.

Kotapati, Srividya; Dequen, P.; Ouwens, MJ; Baardewijk, M van; Ibrahim, R. A.; Wagner, Stefan; Jansen, Jeroen P.

doi:10.1200/jco.2011.29.15_suppl.8580

Cited by 9 publications

(18 citation statements)

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“…The current analysis builds upon a previous systematic review performed by Kotapati et al [18] and presented at ASCO 2011 Annual Meeting. They performed a meta-analysis of 25 of 38 studies reviewed and reported results by treatment, rather than drug class.…”

Section: Discussionmentioning

confidence: 85%

“…The advantage of an NMA based on a network of trials that have interventions in common is that study effects can be separated from treatment effects, thereby limiting bias in a comparison of treatment effects of interventions evaluated in different trials. As an alternative to an NMA, Kotapati et al [18] used the risk equation of Korn et al [6] to adjust for differences in prognostic factors across studies not linked in one network. This relies on the assumption that all differences in prognostic factors across trials, other than treatments compared, are captured by the Korn et al [6] risk equation.…”

Section: Discussionmentioning

confidence: 99%

“…An initial search presented at the American Society of Clinical Oncology (ASCO) 2011 Annual Meeting identified studies published in January 1, 1970 to April 8, 2010 [18]. The cutoff date of 1970 was chosen to ensure all relevant dacarbazine (DTIC) trials were identified.…”

Section: Search Strategy Selection Criteria and Data Extractionmentioning

confidence: 99%

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Systematic Review and Network Meta-Analysis of Overall Survival Comparing 3 mg/kg Ipilimumab With Alternative Therapies in the Management of Pretreated Patients With Unresectable Stage III or IV Melanoma

Dequen¹,

Lorigan

Jansen

et al. 2012

The Oncologist

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Section: Discussionmentioning

confidence: 85%

Section: Discussionmentioning

confidence: 99%

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Systematic Review and Network Meta-Analysis of Overall Survival Comparing 3 mg/kg Ipilimumab With Alternative Therapies in the Management of Pretreated Patients With Unresectable Stage III or IV Melanoma

Dequen¹,

Lorigan

Jansen

et al. 2012

The Oncologist

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“…MDX010-020 is a Phase III RCT for ipilimumab and ipilimumab + gp100 using gp100 as the control [22]. The comparative efficacy of nivolumab and ipilimumab was established via a common comparator of pooled dacarbazine and gp100 and assuming the same efficacy between the two treatments, which is supported by the literature [2,23,24] and decision by NICE for ipilimumab [25]. To enlarge the sample size, patients in the ipilimumab and ipilimumab + gp100 arms in MDX010-020 were pooled to represent ipilimumab monotherapy, which is also supported by the trial results [26].…”

Section: Indirect Treatment Comparison For Nivolumab Ipilimumab Andmentioning

confidence: 92%

The cost-effectiveness of nivolumab monotherapy for the treatment of advanced melanoma patients in England

et al. 2018

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Background Nivolumab was the first programmed death receptor 1 (PD-1) immune checkpoint inhibitor to demonstrate long-term survival benefit in a clinical trial setting for advanced melanoma patients. Objective To evaluate the cost effectiveness of nivolumab monotherapy for the treatment of advanced melanoma patients in England. Methods A Markov state-transition model was developed to estimate the lifetime costs and benefits of nivolumab versus ipilimumab and dacarbazine for BRAF mutation-negative patients and versus ipilimumab, dabrafenib, and vemurafenib for BRAF mutation-positive patients. Covariate-adjusted parametric curves for time to progression, pre-progression survival, and post-progression survival were fitted based on patient-level data from two trials and long-term ipilimumab survival data. Indirect treatment comparisons between nivolumab, ipilimumab, and dacarbazine were informed by these covariate-adjusted parametric curves, controlling for differences in patient characteristics. Kaplan-Meier data from the literature were digitised and used to fit progression-free and overall survival curves for dabrafenib and vemurafenib. Patient utilities and resource use data were based on trial data or the literature. Patients are assumed to receive nivolumab until there is no further clinical benefit, assumed to be the first of progressive disease, unacceptable toxicity, or 2 years of treatment. Results Nivolumab is the most cost-effective treatment option in BRAF mutation-negative and mutation-positive patients, with incremental cost-effectiveness ratios of £24,483 and £17,362 per quality-adjusted life year, respectively. The model results are most sensitive to assumptions regarding treatment duration for nivolumab and the parameters of the fitted parametric survival curves. Conclusions Nivolumab is a cost-effective treatment for advanced melanoma patients in England.

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“…The DTICIpilimumab association achieves an increase of OS related to DTIC in patients with stage III unresected and stage IV previously untreated. A systematic review based on "randomized" studies indicates that the median survival is greater with Ipilimumab plus DTIC related to other combinations in patients with stage III unresected/IV previously untreated (Table 14) [74]. A study presented in the ASCO 2012 meeting [75] shows the results of the association of Ipilimumab plus DTIC versus DTIC plus placebo, being two-year survival (28% versus 18%) and three-year survival (20.8% versus 12.2%) ( < 0.001), with a good safety profile.…”

Section: Newmentioning

confidence: 99%

Adjuvant Treatment of Melanoma

Nogueira¹,

Valero²,

Moreno³

2011

Current Management of Malignant Melanoma

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Melanomas represent 4% of all malignant tumors of the skin, yet account for 80% of deaths from skin cancer.While in the early stages patients can be successfully treated with surgical resection, metastatic melanoma prognosis is dismal. Several oncogenes have been identified in melanoma as BRAF, NRAS, c-Kit, and GNA11 GNAQ, each capable of activating MAPK pathway that increases cell proliferation and promotes angiogenesis, although NRAS and c-Kit also activate PI3 kinase pathway, including being more commonly BRAF activated oncogene. The treatment of choice for localised primary cutaneous melanoma is surgery plus lymphadenectomy if regional lymph nodes are involved. The justification for treatment in addition to surgery is based on the poor prognosis for high risk melanomas with a relapse index of 50-80%. Patients included in the high risk group should be assessed for adjuvant treatment with high doses of Interferon-2b, as it is the only treatment shown to significantly improve disease free and possibly global survival. In the future we will have to analyze all these therapeutic possibilities on specific targets, probably associated with chemotherapy and/or interferon in the adjuvant treatment, if we want to change the natural history of melanomas.

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Overall survival (OS) in the management of pretreated patients with unresectable stage III/IV melanoma: A systematic literature review and meta-analysis.

Cited by 9 publications

References 0 publications

Systematic Review and Network Meta-Analysis of Overall Survival Comparing 3 mg/kg Ipilimumab With Alternative Therapies in the Management of Pretreated Patients With Unresectable Stage III or IV Melanoma

Systematic Review and Network Meta-Analysis of Overall Survival Comparing 3 mg/kg Ipilimumab With Alternative Therapies in the Management of Pretreated Patients With Unresectable Stage III or IV Melanoma

The cost-effectiveness of nivolumab monotherapy for the treatment of advanced melanoma patients in England

Adjuvant Treatment of Melanoma

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