Efficacy and safety of dabrafenib–trametinib in the treatment of unresectable advanced/metastatic melanoma with BRAF‐V600 mutation: A systematic review and network meta‐analysis
| Autor: | Pieralessandro Lasalvia, Diana González-Bravo, Johanna Castrillón, Camilo Castañeda-Cardona, L. Prieto-Pinto, Daniel Herrera, Nathaly Garzón-Orjuela, Diego Rosselli |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Proto-Oncogene Proteins B-raf
Oncology medicine.medical_specialty Skin Neoplasms Pyridones Dacarbazine Network Meta-Analysis Population Ipilimumab Pyrimidinones Dermatology Pembrolizumab 030207 dermatology & venereal diseases 03 medical and health sciences 0302 clinical medicine Internal medicine Antineoplastic Combined Chemotherapy Protocols Oximes Humans Medicine Vemurafenib education Melanoma Trametinib education.field_of_study business.industry Imidazoles Dabrafenib General Medicine 030220 oncology & carcinogenesis Mutation Nivolumab business medicine.drug |
| Zdroj: | Dermatologic Therapy. 33 |
| ISSN: | 1529-8019 1396-0296 |
| DOI: | 10.1111/dth.13145 |
| Popis: | The current systematic review aimed to evaluate and compare the efficacy and safety of dabrafenib-trametinib with those of other therapeutic alternatives in the treatment of patients with unresectable advanced/metastatic melanoma with BRAF-V600 mutation. The search was carried out on four databases up to July 2018. Two separate network meta-analyses (NMA) were performed using the frequentist method (random effects): one with an exclusive population with BRAF-V600 mutation (NMA-pBRAFV600) and another with mixed population (with or without the mutation: NMA-pMixed). An evidence profile was included using the GRADE method for NMA. The validity of the final estimator in the NMA-pMixed was assessed via a sensitivity analysis. Nine clinical trials were included in the NMA-pBRAFV600. Dabrafenib-trametinib was found to have a favorable effect on overall survival (OS) and progression-free survival (PFS) compared with dabrafenib, vemurafenib, and dacarbazine and on partial response rate (PRR) and overall response rate compared with dacarbazine and vemurafenib. In the NMA-pMixed, dabrafenib-trametinib was found to have a positive effect on OS versus ipilimumab 3 mg/kg and on PFS and PRR versus ipilimumab, nivolumab, and pembrolizumab. However, dabrafenib-trametinib and vemurafenib-cobimetinib significantly differed in terms of efficacy. In addition, dabrafenib-trametinib has a favorable effect on Grades 3 and 4 adverse events. |
| Databáze: | OpenAIRE |
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