Safety and efficacy of dual immune checkpoint inhibition for melanoma brain metastases and its comparison to ICI monotherapy: A systematic review and meta-analysis.

What was studied

This review looked at dual immune checkpoint treatment. It was for melanoma that spread to the brain. The studies were prospective and retrospective. The team pooled results on survival, tumor response in the brain and side effects. Some studies compared dual treatment with a single drug. 3518 people were included.

What they found

Survival and response were pooled for the dual group. People without symptoms did better than people with symptoms. Comparisons favored dual treatment over a single drug for survival at 6 months. The same held at 12 months and at 2 years. At 3 years there was no significant difference. High LDH was linked to worse survival. BRAF mutation was not significantly linked to outcome. Dual treatment was linked to more side effects.

What it means for patients

The team said dual treatment gives lasting benefit in the brain. They said this was mainly in people without symptoms and when used early. They said the survival gain must be weighed against heavy toxicity.

Why it is not certain yet

The studies differed a lot from each other. Some were retrospective. The 3-year survival gain is uncertain, due to limited data. Disease with symptoms remains a major unmet need.

Source

Safety and efficacy of dual immune checkpoint inhibition for melanoma brain metastases and its comparison to ICI monotherapy: A systematic review and meta-analysis.

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