Anti-Pd-1/Pd-L1 Inhibitor Therapy for Melanoma Brain Metastases: A Systematic Review and Meta-Analysis Publisher Pubmed



Habibi MA¹ ; Mirjani MS² ; Ahmadvand MH³ ; Delbari P³ ; Eftekhar MS⁴ ; Ghazizadeh Y⁵ ; Ghezel MA^{6, 7} ; Rad RH⁸ ; Vakili KG⁸ ; Lotfi S⁸ ; Minaee P² ; Eazi S² ; Mehrizi MAA⁹ ; Ahmadpour S¹⁰ Show Affiliations
Source: Neurosurgical Review Published:2024

Abstract

Melanoma brain metastases present a major challenge in cancer treatment and reduce overall survival despite advances in managing primary melanoma. Immune checkpoint inhibitors (ICIs) that target PD-1/PD-L1 pathways have shown promise in treating advanced melanoma, but their efficacy for melanoma brain metastases is debated. This systematic review and meta-analysis summarize evidence on anti-PD-1/PD-L1 inhibitors for melanoma brain metastases. This systematic review and meta-analysis followed PRISMA guidelines. PICO criteria targeted melanoma brain metastasis patients treated with PD-1/PD-L1 inhibitors, assessing overall survival, progression-free survival, and complications. Inclusion criteria were English studies on humans using PD-1/PD-L1 inhibitors for melanoma brain metastases with > 10 patients. A total of 22 trials involving 1523 melanoma brain metastase patients treated with anti-PD-1/PD-L1 inhibitors were thoroughly analyzed. Our findings show the 6-month OS rate of 0.75 [95%CI:0.67–0.84], the 6-months PFS rate of 0.42 [95%CI:0.31–0.52], the 1-year OS rate of 0.63 [95%CI:0.52–0.74], the 1-year PFS rate was 0.45 [95%CI:0.32–0.58], the 18-months OS rate of 0.52 [95%CI:0.37–0.67], the 2-year OS rate of 50% [95% CI: (34%-65%)], the 2 year PFS rate of 0.36 (95%CI:0.23–0.50), the 3-year OS rate of 0.42 (95%CI:0.17–0.67), the 4-year PFS rate of 0.35 [95%CI:0.08–0.61], the 4-year OS rate of 0.29 [95%CI:0.01–0.56], the 5-year OS rate of 0.29 (95%CI:0.09–0.50), and the 5-year PFS rate of 0.11 (95%CI:0.03–0.19). The combined disease stability rate was 0.13 [95%CI:0.05–0.20], the progressive disease rate was 0.49 [95%CI:0.37–0.62], the partial response rate was 0.14 [95%CI:0.07–0.20], the object response rate was 0.35 [95%CI:0.24–0.46], and the complete response rate was 0.22 [95%CI:0.12–0.32]. In conclusion, our meta-analysis provides compelling evidence supporting the efficacy of PD-1/PD-L1 inhibitors in patients with melanoma brain tumors, as evidenced by favorable survival outcomes and disease control rates. © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2024.