Li Daishi, Sun Yuming, Le Jiayuan, Dian Yating, Liu Yihuang, Zeng Furong, Deng Guangtong, Lei Shaorong, Su Juan
Central South University, Changsha, China.
National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, Changsha, China.
Int J Dermatol. 2025 Jan;64(1):15-23. doi: 10.1111/ijd.17379. Epub 2024 Aug 4.
The introduction of immunotherapy-based strategies has significantly improved the prognosis for melanoma patients. Nevertheless, some patients still have dismal outcomes, emphasizing the significance of survival predictive indicators in immunotherapy-based approaches. We systematically searched randomized controlled clinical trials investigating dual immunotherapy or chemoimmunotherapy versus placebo or mono-immunotherapy or chemotherapy alone in advanced melanoma patients. R version 4.3.0. was employed to perform all analyses. A comprehensive analysis was conducted on a total of 13,809 patients with advanced melanoma from 19 randomized clinical trials. Immunotherapy-based strategies (alone or in combination) could significantly lengthen the overall survival(OS) and recurrence-free survival (RFS) compared with corresponding controls. Mono-immunotherapy improved RFS and OS in PD-L1 positive patients, in stage AJCC IIIC, and with 4 or more positive lymph nodes, compared with chemotherapy. Combined immunotherapy statistically improved RFS and OS in those aged < 65, with an Eastern Cooperative Oncology Group (ECOG) status of 0, and LDH ≤ ULN at baseline compared with single treatment alone. Our findings indicated that certain clinicopathological and molecular features could assist in choosing appropriate melanoma patients for immune-based treatments.
基于免疫疗法的策略的引入显著改善了黑色素瘤患者的预后。然而，一些患者的预后仍然很差，这凸显了生存预测指标在基于免疫疗法的治疗方法中的重要性。我们系统地检索了调查晚期黑色素瘤患者接受双免疫疗法或化疗免疫疗法与安慰剂或单免疫疗法或单纯化疗相比的随机对照临床试验。使用R版本4.3.0进行所有分析。对来自19项随机临床试验的总共13809例晚期黑色素瘤患者进行了全面分析。与相应对照相比，基于免疫疗法的策略（单独或联合使用）可显著延长总生存期（OS）和无复发生存期（RFS）。与化疗相比，单免疫疗法在PD-L1阳性患者、AJCC IIIC期以及有4个或更多阳性淋巴结的患者中改善了RFS和OS。与单一治疗相比，联合免疫疗法在年龄<65岁、东部肿瘤协作组（ECOG）状态为0且基线时乳酸脱氢酶（LDH）≤正常上限（ULN）的患者中，统计学上改善了RFS和OS。我们的研究结果表明，某些临床病理和分子特征有助于为黑色素瘤患者选择合适的免疫治疗方案。
