The efficacy and safety of nivolumab in the treatment of advanced melanoma: a meta-analysis of clinical trials

Background: Nivolumab has become a therapeutic regimen for the treatment of patients with advanced melanoma. The goal of this study was to assess the efficacy and safety of nivolumab in patients with advanced melanoma. Methods: A systematic search from January 2008 to August 2015 with "nivolumab" and "advanced melanoma" as search terms was performed for possible clinical trials. According to the hazard ratio and the 95% confidence interval (CI) for progression-free survival (PFS), rates of objective response, complete response, partial response, rates of toxic effects, and the efficacy and safety of nivolumab were assessed. Using the software Review Manager (version 5.3) a meta-analysis was performed. Results: There were four trials with 1,910 patients included. Based on the four trials, the pooled hazard ratio of PFS was 0.53 (95%CI, 0.43-0.66; P<0.001). The pooled risk ratio for the objective response rate, complete response, and partial response was 2.98% (95%CI, 2.38%-3.73%; P<0.001), 3.71% (95%CI, 2.67%-5.14%; P<0.001), and 2.51% (95%CI, 2.12%-2.99%; P<0.001), respectively. Nivolumab plus ipilimumab therapy significantly increased the risk of grade 3/4 rash and fatigue. Conclusion: Nivolumab-based therapy prolonged PFS in treatment of advanced melanoma, with less adverse effects. Nivolumab appears to be a favorable treatment option as a novel, targeted anticancer agent, for patients with advanced melanoma.