Immune checkpoint inhibitors for metastatic uveal melanoma: a meta-analysis
Kayoko Yamada, Masaki Takeuchi, Takeshi Fukumoto, Minako Suzuki, Ai Kato, Yuki Mizuki, Norihiro Yamada, Takeshi Kaneko, Nobuhisa Mizuki, Nobuyuki Horita
Abstract
Abstract Several studies have evaluated immune checkpoint inhibitors (ICIs) for metastatic uveal melanoma; however, the efficacy of ICIs in the previous studies varied greatly. In this systematic review, we searched for prospective or retrospective studies on single or dual-ICIs for metastatic uveal melanoma treatment. A random-effect model meta-analysis with generic inverse-variance was conducted, and 36 articles representing 41 cohorts of 1414 patients with metastatic uveal melanoma were included. The pooled outcomes were as follows: objective response rate (ORR) was 5.6% (95% confidence interval [95%CI] 3.7–7.5%; I 2 , 36%), disease control rate (DCR) was 32.5% (95% CI 27.2–37.7%; I 2 , 73%), median progression-free survival was 2.8 months (95% CI 2.7–2.9 months; I 2 , 26%), and median overall survival (OS) was 11.2 months (95% CI 9.6–13.2 months; I 2 , 74%). Compared to single-agent ICI, dual ICI led to better ORR (single-agent: 3.4% [95% CI 1.8–5.1]; dual-agent: 12.4% [95% CI 8.0–16.9]; P < 0.001), DCR (single-agent: 29.3%, [95% CI 23.4–35.2]; dual-agent: 44.3% [95% CI 31.7–56.8]; P = 0.03), and OS (single-agent: 9.8 months [95% CI 8.0–12.2]; dual-agent: 16.3 months [95% CI 13.5–19.7]; P < 0.001). Our analysis provided treatment outcomes as described above. Dual-ICIs appear better than single-agent ICIs for the treatment of metastatic uveal melanoma.