The efficacy and safety of combined immune checkpoint inhibitors (nivolumab plus ipilimumab): a systematic review and meta-analysis
Abstract Background Currently, nivolumab and ipilimumab are the most widely used immune checkpoint inhibitors. We performed a meta-analysis to evaluate the efficacy and treatment-related adverse events (TRAEs) of nivolumab plus ipilimumab therapy in cancer treatment. Methods We examined data from Pu...
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doaj-bf5dad5390034cebb137a61aca4acdfd2020-11-25T03:28:20ZengBMCWorld Journal of Surgical Oncology1477-78192020-07-0118111110.1186/s12957-020-01933-5The efficacy and safety of combined immune checkpoint inhibitors (nivolumab plus ipilimumab): a systematic review and meta-analysisJingjie Chen0Shengnan Li1Qigu Yao2Nannan Du3Xiaojun Fu4Yuanmei Lou5Mengru Wang6Feiyan Mao7Danyi Mao8Parikshit Asutosh Khadaroo9Yingying Tang10Department of General Surgery, HwaMei Hospital, University of Chinese Academy of SciencesThe Second Clinical Medical College, Zhejiang Chinese Medical UniversityState Key Laboratory for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital, College of Medicine, Zhejiang UniversityThe Second Clinical Medical College, Zhejiang Chinese Medical UniversityDepartment of General Surgery, HwaMei Hospital, University of Chinese Academy of SciencesThe Third Clinical Medical College, Zhejiang Chinese Medical UniversityMedical College of Kaifeng UniversityDepartment of General Surgery, HwaMei Hospital, University of Chinese Academy of SciencesBasic Medical College, Zhejiang Chinese Medical UniversityMonash University School of Medicine, Nursing and Health SciencesDepartment of Radiotherapy and Chemotherapy, HwaMei Hospital, University of Chinese Academy of SciencesAbstract Background Currently, nivolumab and ipilimumab are the most widely used immune checkpoint inhibitors. We performed a meta-analysis to evaluate the efficacy and treatment-related adverse events (TRAEs) of nivolumab plus ipilimumab therapy in cancer treatment. Methods We examined data from PubMed, Web of Science, EBSCO, and Cochrane Library. Eleven articles fulfilled our criteria, which we divided into 3 groups: nivolumab plus ipilimumab versus nivolumab (the dose used for monotherapy is 3 mg/kg), nivolumab plus ipilimumab versus ipilimumab (the dose used for monotherapy is 3 mg/kg), and nivolumab 1 mg/kg plus ipilimumab 3 mg/kg (N1I3) versus nivolumab 3 mg/kg plus ipilimumab 1 mg/kg (N3I1). We measured the complete response (CR), partial response (PR), objective response rate (ORR), and TRAEs in any grade and grade 3 or higher. Results The overall effect estimate favored the combined immunotherapy group in terms of the ORR (RR: 1.40, p < 0.001) and PR (RR: 1.50, p < 0.001) than nivolumab alone. Compared with ipilimumab alone, the combined immunotherapy group had better CR (RR: 4.89, p < 0.001), PR (RR: 2.75, p < 0.001), and ORR (RR: 3.31, p < 0.001). Finally, N1I3 showed better PR (RR: 1.35, p = 0.006) and ORR (RR: 1.21, p = 0.03) than N3I1. The incidence of any TRAEs was similar between both groups (RR: 1.05, p = 0.06). However, the incidence of serious adverse events (grade 3 or higher) was lower in group N3I1 than group N1I3 (RR: 1.51, p < 0.001). Conclusion This meta-analysis showed that the curative effect of nivolumab plus ipilimumab was better than that of nivolumab or ipilimumab monotherapy. In the combined immunotherapy group, N1I3 was more effective than N3I1. Although the side effects were slightly increased in N1I3 group, overall safety was acceptable.http://link.springer.com/article/10.1186/s12957-020-01933-5NivolumabIpilimumabTumor responseAdverse eventsMeta-analysis |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Jingjie Chen Shengnan Li Qigu Yao Nannan Du Xiaojun Fu Yuanmei Lou Mengru Wang Feiyan Mao Danyi Mao Parikshit Asutosh Khadaroo Yingying Tang |
spellingShingle |
Jingjie Chen Shengnan Li Qigu Yao Nannan Du Xiaojun Fu Yuanmei Lou Mengru Wang Feiyan Mao Danyi Mao Parikshit Asutosh Khadaroo Yingying Tang The efficacy and safety of combined immune checkpoint inhibitors (nivolumab plus ipilimumab): a systematic review and meta-analysis World Journal of Surgical Oncology Nivolumab Ipilimumab Tumor response Adverse events Meta-analysis |
author_facet |
Jingjie Chen Shengnan Li Qigu Yao Nannan Du Xiaojun Fu Yuanmei Lou Mengru Wang Feiyan Mao Danyi Mao Parikshit Asutosh Khadaroo Yingying Tang |
author_sort |
Jingjie Chen |
title |
The efficacy and safety of combined immune checkpoint inhibitors (nivolumab plus ipilimumab): a systematic review and meta-analysis |
title_short |
The efficacy and safety of combined immune checkpoint inhibitors (nivolumab plus ipilimumab): a systematic review and meta-analysis |
title_full |
The efficacy and safety of combined immune checkpoint inhibitors (nivolumab plus ipilimumab): a systematic review and meta-analysis |
title_fullStr |
The efficacy and safety of combined immune checkpoint inhibitors (nivolumab plus ipilimumab): a systematic review and meta-analysis |
title_full_unstemmed |
The efficacy and safety of combined immune checkpoint inhibitors (nivolumab plus ipilimumab): a systematic review and meta-analysis |
title_sort |
efficacy and safety of combined immune checkpoint inhibitors (nivolumab plus ipilimumab): a systematic review and meta-analysis |
publisher |
BMC |
series |
World Journal of Surgical Oncology |
issn |
1477-7819 |
publishDate |
2020-07-01 |
description |
Abstract Background Currently, nivolumab and ipilimumab are the most widely used immune checkpoint inhibitors. We performed a meta-analysis to evaluate the efficacy and treatment-related adverse events (TRAEs) of nivolumab plus ipilimumab therapy in cancer treatment. Methods We examined data from PubMed, Web of Science, EBSCO, and Cochrane Library. Eleven articles fulfilled our criteria, which we divided into 3 groups: nivolumab plus ipilimumab versus nivolumab (the dose used for monotherapy is 3 mg/kg), nivolumab plus ipilimumab versus ipilimumab (the dose used for monotherapy is 3 mg/kg), and nivolumab 1 mg/kg plus ipilimumab 3 mg/kg (N1I3) versus nivolumab 3 mg/kg plus ipilimumab 1 mg/kg (N3I1). We measured the complete response (CR), partial response (PR), objective response rate (ORR), and TRAEs in any grade and grade 3 or higher. Results The overall effect estimate favored the combined immunotherapy group in terms of the ORR (RR: 1.40, p < 0.001) and PR (RR: 1.50, p < 0.001) than nivolumab alone. Compared with ipilimumab alone, the combined immunotherapy group had better CR (RR: 4.89, p < 0.001), PR (RR: 2.75, p < 0.001), and ORR (RR: 3.31, p < 0.001). Finally, N1I3 showed better PR (RR: 1.35, p = 0.006) and ORR (RR: 1.21, p = 0.03) than N3I1. The incidence of any TRAEs was similar between both groups (RR: 1.05, p = 0.06). However, the incidence of serious adverse events (grade 3 or higher) was lower in group N3I1 than group N1I3 (RR: 1.51, p < 0.001). Conclusion This meta-analysis showed that the curative effect of nivolumab plus ipilimumab was better than that of nivolumab or ipilimumab monotherapy. In the combined immunotherapy group, N1I3 was more effective than N3I1. Although the side effects were slightly increased in N1I3 group, overall safety was acceptable. |
topic |
Nivolumab Ipilimumab Tumor response Adverse events Meta-analysis |
url |
http://link.springer.com/article/10.1186/s12957-020-01933-5 |
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