التفاصيل البيبلوغرافية
| العنوان: |
Neoadjuvant Immunotherapy for Regional Metastatic Melanoma: A Systemic Review and Meta-analysis. |
| المؤلفون: |
Belnap, A.1 (AUTHOR), Bergeron, J.1 (AUTHOR), Dial, M.1 (AUTHOR), McCoul, E.2 (AUTHOR), Moore, B.2 (AUTHOR) |
| المصدر: |
International Journal of Radiation Oncology, Biology, Physics. Apr2024, Vol. 118 Issue 5, pe85-e85. 1p. |
| مصطلحات موضوعية: |
*HEAD & neck cancer, *DRUG side effects, *IMMUNOTHERAPY, *MELANOMA, *NEOADJUVANT chemotherapy, *RANDOMIZED controlled trials |
| مستخلص: |
Neoadjuvant immunotherapy has emerged as a potential solution to improve outcomes for patients with advanced resectable melanoma, particularly in the head and neck region, where the disease is prevalent. Despite advances in adjuvant immunotherapy, locally advanced melanoma continues to pose significant morbidity and mortality challenges. This review aims to evaluate the effectiveness of neoadjuvant immunotherapy for stage III locally metastatic melanoma, considering its impact on pathological response and adverse events. Following PRISMA guidelines, a comprehensive search was conducted across PubMed, Embase, and Web of Science, yielding 1,257 results, with 88 studies selected for full-text review. Inclusion criteria encompassed English language studies of patients aged over 18 with stage III melanoma treated with neoadjuvant immunotherapies. Various study designs, including randomized controlled trials, prospective cohorts, case-control, and case series, were considered. Quality assessment was performed using relevant checklists. 6 studies were included in the final analysis, each with different treatment regimens. Notably, neoadjuvant immunotherapy demonstrated the potential to induce a major pathological response (MPR), associated with improved survival. Radiological response consistently underestimated pathological response. Immune-related adverse events (irAEs) were common, with grade 3+ toxicity varying between 10% and 90%. A meta-analysis revealed improved 3-year relapse-free survival (RFS) with neoadjuvant immunotherapy compared to adjuvant, albeit not statistically significant. IrAE rates were similar between the two approaches. Neoadjuvant immunotherapy demonstrates potential in enhancing survival and reducing tumor burden in stage III melanoma patients, with a particular focus on head and neck cases. Pathological response surfaces as a predictor of outcomes and may influence surgical decisions. While meta-analysis results hint at improved survival with neoadjuvant therapy, larger studies are required for definitive conclusions. Addressing irAEs and optimizing treatment regimens remain crucial for future research in this field. [ABSTRACT FROM AUTHOR] |
| قاعدة البيانات: |
Academic Search Index |
