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Dacarbazine combined targeted therapy versus dacarbazine alone in patients with malignant melanoma: a meta-analysis.

Jiang G, Li RH, Sun C, Liu YQ, Zheng JN - PLoS ONE (2014)

Bottom Line: The primary outcome measures were overall response and 1-year survival, and the secondary outcome measurements were adverse events.Patients with DTIC-based combination therapies had higher incidence of adverse events including nausea (combined RR = 1.23, 95% CI: 1.10-1.36), vomiting (combined RR = 1.73, 95% CI: 1.41-2.12) and neutropenia (combined RR = 1.75, 95% CI: 1.42-2.16) compared to the group for DTIC alone.These data suggested that DTIC-based combination therapies could moderately improve the overall response and the 1-year survival but increased the incidence of adverse events.

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology, Affiliated Hospital of Xuzhou Medical College, Xuzhou, 221002, China; Jiangsu Key Laboratory of Biological Cancer Therapy, Xuzhou Medical College, Xuzhou, 221002, China; Center for Disease Control and Prevention of Xuzhou City, Xuzhou, 221002, China.

ABSTRACT

Background: Malignant melanoma is the most aggressive and deadly form of skin cancer. Dacarbazine (DTIC) has been the approved first-line treatment for metastatic melanoma in routine clinical practice. However, response rates with single-agent DTIC are low. The objective of this study was to compare the efficacy and safety of DTIC with or without placebo and DTIC-based combination therapies in patients with advanced metastatic melanoma.

Methods: We searched from electronic databases such as The Cochrane Library, MEDLINE, EBSCO, EMBASE, Ovid, CNKI, and CBMDisc from 2003 to 2013. The primary outcome measures were overall response and 1-year survival, and the secondary outcome measurements were adverse events.

Results: Nine randomized controlled trials (RCTs) involving 2,481 patients were included in the meta-analysis. DTIC-based combination therapies was superior to DTIC alone in overall response (combined risk ratio [RR]  = 1.60, 95% confidence interval [CI]: 1.27-2.01) and 1-year survival (combined RR = 1.26, 95% CI: 1.14-1.39). Patients with DTIC-based combination therapies had higher incidence of adverse events including nausea (combined RR = 1.23, 95% CI: 1.10-1.36), vomiting (combined RR = 1.73, 95% CI: 1.41-2.12) and neutropenia (combined RR = 1.75, 95% CI: 1.42-2.16) compared to the group for DTIC alone.

Conclusion: These data suggested that DTIC-based combination therapies could moderately improve the overall response and the 1-year survival but increased the incidence of adverse events. Further large-scale, high-quality, placebo-controlled, double-blind trials are needed to confirm this conclusion.

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Related in: MedlinePlus

Risk of bias. (a) percentile chart and (b) summary diagram.
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pone-0111920-g002: Risk of bias. (a) percentile chart and (b) summary diagram.

Mentions: We evaluated the methodological quality of the included literature according to the RCT quality evaluation standard of the Cochrane Handbook for Systematic Reviews of Interventions, Version 5.0.0 (Fig. 2a). For each included study, two reviewers independently completed and assessed methodological quality.


Dacarbazine combined targeted therapy versus dacarbazine alone in patients with malignant melanoma: a meta-analysis.

Jiang G, Li RH, Sun C, Liu YQ, Zheng JN - PLoS ONE (2014)

Risk of bias. (a) percentile chart and (b) summary diagram.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4263472&req=5

pone-0111920-g002: Risk of bias. (a) percentile chart and (b) summary diagram.
Mentions: We evaluated the methodological quality of the included literature according to the RCT quality evaluation standard of the Cochrane Handbook for Systematic Reviews of Interventions, Version 5.0.0 (Fig. 2a). For each included study, two reviewers independently completed and assessed methodological quality.

Bottom Line: The primary outcome measures were overall response and 1-year survival, and the secondary outcome measurements were adverse events.Patients with DTIC-based combination therapies had higher incidence of adverse events including nausea (combined RR = 1.23, 95% CI: 1.10-1.36), vomiting (combined RR = 1.73, 95% CI: 1.41-2.12) and neutropenia (combined RR = 1.75, 95% CI: 1.42-2.16) compared to the group for DTIC alone.These data suggested that DTIC-based combination therapies could moderately improve the overall response and the 1-year survival but increased the incidence of adverse events.

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology, Affiliated Hospital of Xuzhou Medical College, Xuzhou, 221002, China; Jiangsu Key Laboratory of Biological Cancer Therapy, Xuzhou Medical College, Xuzhou, 221002, China; Center for Disease Control and Prevention of Xuzhou City, Xuzhou, 221002, China.

ABSTRACT

Background: Malignant melanoma is the most aggressive and deadly form of skin cancer. Dacarbazine (DTIC) has been the approved first-line treatment for metastatic melanoma in routine clinical practice. However, response rates with single-agent DTIC are low. The objective of this study was to compare the efficacy and safety of DTIC with or without placebo and DTIC-based combination therapies in patients with advanced metastatic melanoma.

Methods: We searched from electronic databases such as The Cochrane Library, MEDLINE, EBSCO, EMBASE, Ovid, CNKI, and CBMDisc from 2003 to 2013. The primary outcome measures were overall response and 1-year survival, and the secondary outcome measurements were adverse events.

Results: Nine randomized controlled trials (RCTs) involving 2,481 patients were included in the meta-analysis. DTIC-based combination therapies was superior to DTIC alone in overall response (combined risk ratio [RR]  = 1.60, 95% confidence interval [CI]: 1.27-2.01) and 1-year survival (combined RR = 1.26, 95% CI: 1.14-1.39). Patients with DTIC-based combination therapies had higher incidence of adverse events including nausea (combined RR = 1.23, 95% CI: 1.10-1.36), vomiting (combined RR = 1.73, 95% CI: 1.41-2.12) and neutropenia (combined RR = 1.75, 95% CI: 1.42-2.16) compared to the group for DTIC alone.

Conclusion: These data suggested that DTIC-based combination therapies could moderately improve the overall response and the 1-year survival but increased the incidence of adverse events. Further large-scale, high-quality, placebo-controlled, double-blind trials are needed to confirm this conclusion.

Show MeSH
Related in: MedlinePlus