All patients
Age < 65y (younger) Age > 65y Age > 75y (older) BRAF mutant BRAF wild type ECOG ⩾ 1 ECOG 0 ECOG 1 Gender, female Gender, male LDH > ULN LDH ≤ULN metastasis (brain) NO metastasis (brain) YES metastasis (liver ) PD-L1 < 1% PD-L1 < 5% PD-L1 > 1% PD-L1 > 5% PDL1 (TC0 and IC0 : <1% of TC and IC) PDL1 (TC1/2/3 or IC1/2/3 : ≥1% of TC or IC) Prior anti-CTLA4 benefit NO Prior anti-CTLA4 benefit YES stage III (locally advanced) stage IIIc stage IV (metastatic) stage M0 stage M0/M1A/M1B stage M1A stage M1B stage M1C
Top evidence (RCT only, high risk of bias excluded)
Best available evidence (possibly low or very low)
All RCTs
All studies (RCT+OBS)
studies
mML - 1st line (L1), immune chekpoint inhibitors vs. Standard of Care (SoC), meta-analysis of study results Outcome TE 95% CI n k I2 ROB Pub. bias deaths (OS)detailed results A3671009, 2013 0.88 [0.75; 1.04]
IMspire-150 (BRAF mutant), 2020 0.85 [0.65; 1.12]
0.87 [0.76 ; 1.00 ] A3671009, 2013, IMspire-150 (BRAF mutant), 2020 2 0% 1,169 moderate not evaluable progression or deaths (PFS)detailed results IMspire-150 (BRAF mutant), 2020 0.78 [0.63; 0.97]
0.78 [0.63 ; 0.97 ] IMspire-150 (BRAF mutant), 2020 1 0% 514 NA not evaluable objective responses (ORR)detailed results A3671009, 2013 1.14 [0.69; 1.88]
IMspire-150 (BRAF mutant), 2020 1.19 [0.83; 1.71]
1.17 [0.87 ; 1.57 ] A3671009, 2013, IMspire-150 (BRAF mutant), 2020 2 0% 1,169 low not evaluable AE (any grade)detailed results A3671009, 2013 2.22 [1.12; 4.38]
2.22 [1.12 ; 4.38 ] A3671009, 2013 1 0% 644 NA not evaluable AE (grade 3-4)detailed results A3671009, 2013 1.84 [1.35; 2.52]
1.84 [1.35 ; 2.52 ] A3671009, 2013 1 0% 644 NA not evaluable AE leading to death (grade 5)detailed results A3671009, 2013 1.71 [0.85; 3.45]
IMspire-150 (BRAF mutant), 2020 1.23 [0.42; 3.56]
1.55 [0.86 ; 2.78 ] A3671009, 2013, IMspire-150 (BRAF mutant), 2020 2 0% 1,155 moderate not evaluable AE leading to treatment discontinuation (any grade)detailed results A3671009, 2013 97.13 [5.95; 1585.40]
IMspire-150 (BRAF mutant), 2020 0.78 [0.47; 1.29]
7.09 [0.06 ; 791.12 ] A3671009, 2013, IMspire-150 (BRAF mutant), 2020 2 91% 1,155 low not evaluable SAE (any grade)detailed results A3671009, 2013 3.19 [2.19; 4.65]
3.19 [2.19 ; 4.65 ] A3671009, 2013 1 0% 644 NA not evaluable STRAE (any grade)detailed results IMspire-150 (BRAF mutant), 2020 1.24 [0.85; 1.81]
1.24 [0.85 ; 1.81 ] IMspire-150 (BRAF mutant), 2020 1 0% 511 NA not evaluable TRAE (any grade)detailed results IMspire-150 (BRAF mutant), 2020 0.82 [0.11; 5.85]
0.82 [0.11 ; 5.85 ] IMspire-150 (BRAF mutant), 2020 1 0% 511 NA not evaluable TRAE (grade 3-4)detailed results IMspire-150 (BRAF mutant), 2020 1.41 [0.93; 2.12]
1.41 [0.93 ; 2.12 ] IMspire-150 (BRAF mutant), 2020 1 0% 511 NA not evaluable TRAE leading to death (grade 5)detailed results A3671009, 2013 7.00 [0.86; 57.23]
7.00 [0.86 ; 57.23 ] A3671009, 2013 1 0% 644 NA not evaluable Adrenal insufficiency TRAE (grade 3-4)detailed results A3671009, 2013 5.93 [0.30; 118.96]
5.93 [0.30 ; 118.96 ] A3671009, 2013 1 0% 644 NA not evaluable Arthralgia TRAE (grade 3-4)detailed results IMspire-150 (BRAF mutant), 2020 1.44 [0.48; 4.34]
1.44 [0.48 ; 4.34 ] IMspire-150 (BRAF mutant), 2020 1 0% 511 NA not evaluable Asthenia TRAE (grade 3-4)detailed results IMspire-150 (BRAF mutant), 2020 2.47 [0.45; 13.60]
2.47 [0.45 ; 13.60 ] IMspire-150 (BRAF mutant), 2020 1 0% 511 NA not evaluable Blood creatinine increased TRAE (grade 3-4)detailed results IMspire-150 (BRAF mutant), 2020 0.61 [0.02; 18.27]
0.61 [0.02 ; 18.27 ] IMspire-150 (BRAF mutant), 2020 1 0% 511 NA not evaluable Chorioretinopathy TRAE (grade 3-4)detailed results IMspire-150 (BRAF mutant), 2020 0.61 [0.02; 18.27]
0.61 [0.02 ; 18.27 ] IMspire-150 (BRAF mutant), 2020 1 0% 511 NA not evaluable Decreased appetite TRAE (grade 3-4)detailed results IMspire-150 (BRAF mutant), 2020 0.30 [0.01; 6.77]
0.30 [0.01 ; 6.77 ] IMspire-150 (BRAF mutant), 2020 1 0% 511 NA not evaluable Diarrhoea TRAE (grade 3-4)detailed results IMspire-150 (BRAF mutant), 2020 0.53 [0.16; 1.76]
0.53 [0.16 ; 1.76 ] IMspire-150 (BRAF mutant), 2020 1 0% 511 NA not evaluable Dry skin TRAE (grade 3-4)detailed results IMspire-150 (BRAF mutant), 2020 4.92 [0.22; 109.67]
4.92 [0.22 ; 109.67 ] IMspire-150 (BRAF mutant), 2020 1 0% 511 NA not evaluable Erythema TRAE (grade 3-4)detailed results IMspire-150 (BRAF mutant), 2020 7.41 [0.37; 148.78]
7.41 [0.37 ; 148.78 ] IMspire-150 (BRAF mutant), 2020 1 0% 511 NA not evaluable Eye disorders TRAE (grade 3-4)detailed results A3671009, 2013 0.98 [0.02; 49.62]
0.98 [0.02 ; 49.62 ] A3671009, 2013 1 0% 644 NA not evaluable Fatigue TRAE (grade 3-4)detailed results IMspire-150 (BRAF mutant), 2020 3.70 [0.38; 35.82]
3.70 [0.38 ; 35.82 ] IMspire-150 (BRAF mutant), 2020 1 0% 511 NA not evaluable Hepatitis TRAE (grade 3-4)detailed results A3671009, 2013 3.94 [0.18; 87.81]
3.94 [0.18 ; 87.81 ] A3671009, 2013 1 0% 644 NA not evaluable Hyperthyroidism TRAE (grade 3-4)detailed results IMspire-150 (BRAF mutant), 2020 4.92 [0.22; 109.67]
4.92 [0.22 ; 109.67 ] IMspire-150 (BRAF mutant), 2020 1 0% 511 NA not evaluable Increased lipase level TRAE (grade 3-4)detailed results IMspire-150 (BRAF mutant), 2020 0.99 [0.64; 1.52]
0.99 [0.64 ; 1.52 ] IMspire-150 (BRAF mutant), 2020 1 0% 511 NA not evaluable Maculopapular rash TRAE (grade 3-4)detailed results IMspire-150 (BRAF mutant), 2020 1.36 [0.78; 2.37]
1.36 [0.78 ; 2.37 ] IMspire-150 (BRAF mutant), 2020 1 0% 511 NA not evaluable Myalgia TRAE (grade 3-4)detailed results IMspire-150 (BRAF mutant), 2020 2.46 [0.22; 27.26]
2.46 [0.22 ; 27.26 ] IMspire-150 (BRAF mutant), 2020 1 0% 511 NA not evaluable Nausea TRAE (grade 3-4)detailed results IMspire-150 (BRAF mutant), 2020 0.17 [0.02; 1.40]
0.17 [0.02 ; 1.40 ] IMspire-150 (BRAF mutant), 2020 1 0% 511 NA not evaluable Pancreatitis TRAE (grade 3-4)detailed results A3671009, 2013 5.93 [0.30; 118.96]
5.93 [0.30 ; 118.96 ] A3671009, 2013 1 0% 644 NA not evaluable Peripheral oedema TRAE (grade 3-4)detailed results IMspire-150 (BRAF mutant), 2020 1.22 [0.02; 61.84]
1.22 [0.02 ; 61.84 ] IMspire-150 (BRAF mutant), 2020 1 0% 511 NA not evaluable Pneumonitis TRAE (grade 3-4)detailed results IMspire-150 (BRAF mutant), 2020 4.92 [0.22; 109.67]
4.92 [0.22 ; 109.67 ] IMspire-150 (BRAF mutant), 2020 1 0% 511 NA not evaluable Pruritus TRAE (grade 3-4)detailed results IMspire-150 (BRAF mutant), 2020 2.46 [0.22; 27.26]
2.46 [0.22 ; 27.26 ] IMspire-150 (BRAF mutant), 2020 1 0% 511 NA not evaluable Pyrexia TRAE (grade 3-4)detailed results IMspire-150 (BRAF mutant), 2020 1.22 [0.24; 6.13]
1.22 [0.24 ; 6.13 ] IMspire-150 (BRAF mutant), 2020 1 0% 511 NA not evaluable Rash TRAE (grade 3-4)detailed results IMspire-150 (BRAF mutant), 2020 0.98 [0.53; 1.81]
0.98 [0.53 ; 1.81 ] IMspire-150 (BRAF mutant), 2020 1 0% 511 NA not evaluable Vomiting TRAE (grade 3-4)detailed results IMspire-150 (BRAF mutant), 2020 0.48 [0.09; 2.52]
0.48 [0.09 ; 2.52 ] IMspire-150 (BRAF mutant), 2020 1 0% 511 NA not evaluable Abdominal pain AE (grade 3-4)detailed results A3671009, 2013 4.04 [1.13; 14.45]
4.04 [1.13 ; 14.45 ] A3671009, 2013 1 0% 644 NA not evaluable Asthenia AE (grade 3-4)detailed results A3671009, 2013 0.10 [0.01; 1.78]
0.10 [0.01 ; 1.78 ] A3671009, 2013 1 0% 644 NA not evaluable Constipation AE (grade 3-4)detailed results A3671009, 2013 0.98 [0.14; 7.01]
0.98 [0.14 ; 7.01 ] A3671009, 2013 1 0% 644 NA not evaluable Cough AE (grade 3-4)detailed results A3671009, 2013 1.97 [0.07; 58.81]
1.97 [0.07 ; 58.81 ] A3671009, 2013 1 0% 644 NA not evaluable Decreased appetite AE (grade 3-4)detailed results A3671009, 2013 14.32 [1.87; 109.52]
14.32 [1.87 ; 109.52 ] A3671009, 2013 1 0% 644 NA not evaluable Dyspnoea AE (grade 3-4)detailed results A3671009, 2013 4.00 [0.84; 18.98]
4.00 [0.84 ; 18.98 ] A3671009, 2013 1 0% 644 NA not evaluable Fatigue AE (grade 3-4)detailed results A3671009, 2013 3.90 [1.44; 10.57]
3.90 [1.44 ; 10.57 ] A3671009, 2013 1 0% 644 NA not evaluable Headache AE (grade 3-4)detailed results A3671009, 2013 1.97 [0.18; 21.82]
1.97 [0.18 ; 21.82 ] A3671009, 2013 1 0% 644 NA not evaluable Hypothyroidism AE (grade 3-4)detailed results IMspire-150 (BRAF mutant), 2020 1.22 [0.02; 61.84]
1.22 [0.02 ; 61.84 ] IMspire-150 (BRAF mutant), 2020 1 0% 511 NA not evaluable Nausea AE (grade 3-4)detailed results A3671009, 2013 1.39 [0.61; 3.18]
1.39 [0.61 ; 3.18 ] A3671009, 2013 1 0% 644 NA not evaluable Neutropenia AE (grade 3-4)detailed results A3671009, 2013 0.03 [0.00; 0.19]
0.03 [0.00 ; 0.19 ] A3671009, 2013 1 0% 644 NA not evaluable Peripheral oedema AE (grade 3-4)detailed results A3671009, 2013 4.97 [0.58; 42.77]
4.97 [0.58 ; 42.77 ] A3671009, 2013 1 0% 644 NA not evaluable Pruritus AE (grade 3-4)detailed results A3671009, 2013 5.93 [0.30; 118.96]
5.93 [0.30 ; 118.96 ] A3671009, 2013 1 0% 644 NA not evaluable Pyrexia AE (grade 3-4)detailed results A3671009, 2013 7.94 [0.42; 150.76]
7.94 [0.42 ; 150.76 ] A3671009, 2013 1 0% 644 NA not evaluable Rash AE (grade 3-4)detailed results A3671009, 2013 7.00 [0.86; 57.23]
7.00 [0.86 ; 57.23 ] A3671009, 2013 1 0% 644 NA not evaluable Thrombocytopenia AE (grade 3-4)detailed results A3671009, 2013 0.03 [0.00; 0.26]
0.03 [0.00 ; 0.26 ] A3671009, 2013 1 0% 644 NA not evaluable Vomiting AE (grade 3-4)detailed results A3671009, 2013 1.55 [0.66; 3.64]
1.55 [0.66 ; 3.64 ] A3671009, 2013 1 0% 644 NA not evaluable Weight decreased AE (grade 3-4)detailed results A3671009, 2013 0.98 [0.06; 15.76]
0.98 [0.06 ; 15.76 ] A3671009, 2013 1 0% 644 NA not evaluable 0.0 20.0 1.0 relative treatment effect www.metaEvidence.org 2024-10-05 15:02 +02:00
TE: relative treatment effect (measured by a risk ratio, an odds ratio or an hazard ratio depending on what is reported in the papers);
k: number of studies; n: total number of patients;
ROB: risk of bias (ROB 2.0); Pub. bias: publication bias; OBS: observational studies; RCT: randomized clinical trials
studied treatment is better when TE > 1;
studied treatment is better when TE < 1;
pathologies: 285,68,127,128
- treatments: 204,504,850,329,558,579,549,868,502,741,556,812,813,367,851,361,602,1070,671,865,744,696,1083,1281,1282,1283,1082,866,852,417,603,1051,876,853,1018,661,673,1049,1440,1561,854,374,953,672,1080,1560,1073,862,1562,1565,855,360,719,721,720,842,642,674,1085,863,503,847,982,359,575,577,576,869,1081,981,875,505,952,1021,1079,767,1071,1074,873,561,644,1251,1044,724,874,1043,1041,1042,940,1258,1563,746,745,856,634,861,416,864,769,980,369,743