Efficacy And Safety Of Ipilimumab For Advanced Melanoma:a Meta-analysis

Objective: We conduct a meta-analysis is to evaluate the clinical efficacy and safety of ipilimumab for advanced melanoma.Methods: We searched Pubmed,the Cochrane Library,Embase,CNKI,Wanfang and VIP detabase.Two reviewers independently evaluated the quality of the included studies and extracted the data.Meta-analysis was performed by Rev Man 5.3 software.Results: Four randomized controlled trials involving 2622 patients were included.The results of meta-analyses showed that there were significant difference of the progression-free survival rate at 1 year(RR = 0.94,95% CI: 0.91~0.98,P = 0.001)and overall survival rate at 1 year(RR = 0.79,95% CI: 0.72~0.87,P<0.00001)between the two groups,However,there were no significant differences of the progression-free survival rate at 2 year(RR = 0.99,95%CI: 0.97~1.01,P = 0.45)and overall survival rate at 3 year(RR = 0.93,95% CI: 0.84~1.03,P=0.17)between the two groups.The cutaneous,gastrointestinal and hepatic adverse events showed significant differences between the two groups in pruritu(RR = 2.35,95% CI:1.67 ~3.29,P<0.00001),rash(RR = 2.43,95%CI:1.64~3.61,P<0.00001),diarrhea(RR = 1.82,95% CI:1.47~2.25,P<0.00001),colitis(RR = 11.21,95% CI: 6.20~20.30,P<0.00001),increase in alanine aminotransferase(RR = 3.57,95%CI:1.92~6.62,P<0.00001),increase in aspartate aminotransferase(RR = 3.81,95% CI: 2.85~5.09,P<0.00001).Conclusion: Ipilimumab can increase progression-free survival rate at 1 year and overall survival rate at 1 year for advanced melanoma.However,ipilimumab showed no remarkable advantage in Progression-free survival rate at 2 year and overall survival rate at 3 year.Ipilimumab increased risk of pruritu,rash,diarrhea,colitis,increase in alanine aminotransferase,increase in aspartate aminotransferase.