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A Network Meta‐Analysis of Short and Long‐Term Efficacy of Targeted Therapy With Single or Double‐Drug Regimens in the Treatment of Stage III/IV Malignant Melanoma Based on 16 Randomized Controlled Trials
Authors:Ting Xie  Chun‐Yu Huang  Xu Kang  Jia‐Sheng Luo  Xiao‐Min Qin  Feng Han
Institution:1. Department of Dermatology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, P. R. China;2. Department of Endoscopy, Sun Yat‐sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, P. R. China;3. Department of Ultrasound, Sun Yat‐sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, P. R. China
Abstract:For the treatment of stage III/IV malignant melanoma (MM), a network meta‐analysis (NMA) was conducted to compare the short and long‐term efficacy of targeted therapy with single or double‐drug regimens. All conducted randomized controlled trials (RCTs) searched from PubMed and Cochrane Library were included in the study for direct and indirect comparison for MM. The odds ratio (OR) and surface under the cumulative ranking curves (SUCRA) value of the targeted therapy with single or double‐drug regimens for treatment of stage III/IV MM were also analyzed. To group the treatments according to their similarity with regards to both outcomes, cluster analyses were performed. Ultimately, 16 RCTs were incorporated for this NMA. The NMA revealed that the overall response rate (ORR) values of single‐drug regimens (Vemurafenib Vem], Dabrafenib Dab], and Nivolumab Niv]) were higher than those of Dacarbazine (Dac). Also the ORR values of double‐drug regimens (Dab + Trametinib Dab + Tra], Niv + Ipilimumab Niv + Ipi], and Vem + Cobimetinib Vem + Cob]) were moderately higher than those of Dac. The results of the SUCRA showed that short‐term efficacy of single‐drug regimens (Vem and Dab) were better, while the short‐term efficacy of double‐drug regimens (Dab + Tra and Vem + Cob) were relatively better. It was determined that Vem, Dab, and Niv might be the best choice in evaluating the treatment of stage III/IV MM among different single‐drug targeted therapy regimens, while Dab + Tra, Niv + Ipi, and Vem + Cob might have better short‐term efficacy among different double‐drug targeted therapy regimens. J. Cell. Biochem. 119: 640–649, 2018. © 2017 Wiley Periodicals, Inc.
Keywords:MALIGNANT MELANOMA  TARGETED THERAPY  SHORT‐TERM EFFICACY  LONG‐TERM EFFICACY  RANDOMIZED CONTROLLED TRIALS  NETWORK META‐ANALYSIS  OVERALL RESPONSE RATE  SURFACE UNDER THE CUMULATIVE RANKING CURVES  SINGLE‐DRUG  DOUBLE‐DRUG
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