Evidence map›Paper›PMID 27167347›Full record

SynthesisCancer medicine2016

Targeting immune checkpoints in unresectable metastatic cutaneous melanoma: a systematic review and meta-analysis of anti-CTLA-4 and anti-PD-1 agents trials.

Seongseok Yun, Nicole D Vincelette, Myke R Green, Andrea E Wahner Hendrickson, Ivo Abraham

Open access · goldAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Cancer medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 62 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
62citing papers in PubMed, 6 pooled it
6.1field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

62 citing papers in PubMed, 6 syntheses or guidelines pooled it, 97 citations in OpenAlex.

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  7. Role of pyroptosis in melanoma: Molecular mechanisms and therapeutic potentials.Apoptosis : an international journal on programmed cell death · 2026
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2 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 1 country.

Seongseok YunDepartment of Medicine, University of Arizona, Tucson, Arizona, 85721.ORCID 0000-0001-7343-1635
Nicole D VinceletteMolecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, Minnesota, 55905.
Myke R GreenHematology and Oncology, University of Arizona, Tucson, Arizona, 85721.
Andrea E Wahner HendricksonMedical Oncology, Mayo Clinic, Rochester, Minnesota, 55905.
Ivo AbrahamCenter for Health Outcomes and PharmacoEconomic Research, University of Arizona, Tucson, Arizona, 85721.
University of Arizona · USMayo Clinic · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Anti-cytotoxic T lymphocyte-associated antigen-4 (CTLA-4) and anti-programmed cell death-1 (PD-1) inhibitors have been shown to significantly improve survival in patients with metastatic cutaneous melanoma. However, there was some heterogeneity as well as some variation in the degree of benefit across studies. We reviewed randomized trials and performed a meta-analysis to determine the efficacy and safety of immune checkpoint inhibitors in comparison with conventional regimens. Eligible studies were limited to randomized controlled trials comparing anti-CTLA-4 or anti-PD-1 inhibitors to chemotherapy or vaccination treatment in adult patients with unresectable cutaneous metastatic melanoma. Progression-free survival (PFS) rate at 6 months was 28.5% versus 17.7% (RR: 0.84, 95% CI: 0.76-0.93), overall survival (OS) rate at 1 year was 51.2% versus 38.8% (RR: 0.72, 95% CI: 0.59-0.88), and overall response rate (ORR) at 6 months was 29.6% versus 17.7% (RR: 0.85, 95% CI: 0.76-0.95) favoring immune check point inhibitors over chemotherapies or vaccination. Immune check point inhibitors were associated with more frequent immune-related adverse events at 13.7% versus 2.4% of treated patients (RR: 6.74, 95% CI: 4.65-9.75). Subgroup analyses demonstrated significant PFS (RR: 0.92 vs. 0.74, P < 0.00001) and ORR (RR: 0.95 vs. 0.76, P = 0.0004) improvement with anti-PD-1 treatment compared to anti-CTLA-4 when each of them was compared to control treatments. Collectively, these results demonstrate that immune checkpoint inhibitors have superior outcomes compared to conventional chemotherapies or vaccination, and support the results of recent randomized trials that showed superior outcomes with anti-PD-1 agents over ipilimumab in unresectable metastatic cutaneous melanoma patients.

Indexed as

Molecular Targeted TherapyAntibodies, MonoclonalAntineoplastic AgentsClinical Trials as TopicCTLA-4 AntigenCutaneous Malignant MelanomaHumansMelanomaNeoplasm MetastasisNeoplasm StagingOdds RatioPrognosisProgrammed Cell Death 1 ReceptorPublication BiasSkin NeoplasmsTreatment OutcomeAntibodies, MonoclonalAntineoplastic AgentsCTLA-4 AntigenProgrammed Cell Death 1 ReceptorCTLA-4IpilimumabLambrolizumabmetastatic melanomanivolumabPD-1pembrolizumabtremelimumab

Identifiers

PMID27167347
PMCPMC4867662
OpenAlexW2376844206

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.