Precision Xtract, Vancouver, British Columbia, V6H 3Y4, Canada.
Novartis Pharmaceuticals Corporation, East Hanover, NJ 07936, USA.
J Comp Eff Res. 2019 Dec;8(16):1349-1363. doi: 10.2217/cer-2019-0061. Epub 2019 Nov 28.
To conduct a systematic literature review of high-risk resectable cutaneous melanoma adjuvant therapeutics and compare safety and efficacy. The systematic literature review included randomized controlled trials investigating: dabrafenib plus trametinib (DAB + TRAM), nivolumab, pembrolizumab, ipilimumab, vemurafenib, chemotherapy and interferons. Outcomes included overall survival (OS), relapse-free survival, distant metastasis-free survival and safety. All outcomes were synthesized using Bayesian network meta-analysis. Across relapse-free survival, distant metastasis-free survival and OS, DAB + TRAM had the lowest estimated hazards of respective events relative to all other treatments (exception relative to nivolumab in OS). Differences were significant relative to placebo, chemotherapy, interferons and ipilimumab. DAB + TRAM has improved efficacy over historical treatment options (ipilimumab, interferons and chemotherapy) and comparable efficacy with other targeted and immune checkpoint inhibitors.
进行一项关于高风险可切除皮肤黑色素瘤辅助治疗的系统文献回顾，并比较安全性和疗效。系统文献回顾包括随机对照试验，研究了达布拉非尼联合曲美替尼（DAB+TRAM）、纳武利尤单抗、帕博利珠单抗、伊匹单抗、维莫非尼、化疗和干扰素。结果包括总生存期（OS）、无复发生存期、无远处转移生存期和安全性。所有结果均采用贝叶斯网络荟萃分析进行综合。在无复发生存期、无远处转移生存期和 OS 方面，DAB+TRAM 相对于所有其他治疗方法（OS 中相对纳武利尤单抗的情况除外），相应事件的估计风险最低。与安慰剂、化疗、干扰素和伊匹单抗相比，差异具有统计学意义。DAB+TRAM 的疗效优于历史治疗选择（伊匹单抗、干扰素和化疗），与其他靶向和免疫检查点抑制剂的疗效相当。
