Wu Y, et al. – This study was undertaken to gauge the clinical value of a combination of immune checkpoint inhibitors in cancer patients. It was indicated that the addition of nivolumab to ipilimumab better benefited progression-free survival (PFS) and overall response rate (ORR). As per the observations, adding sargramostim resulted in better overall survival (OS) and safety. Experts proposed for further assessment of efficacy and safety of a nivolumab–ipilimumab–sargramostim combination.

Methods

• Clinical trials that evaluated ICI monotherapies and combination therapies in lung cancer and melanoma patients, were searched.
• In order to determine the relative risk (RR), hazard ratios (HRs), and 95% confidence intervals (Cis), the overall response rate (ORR), grade 3/4 treatment-related adverse event rate, overall survival (OS), and progression-free survival (PFS) were extracted from the most recently published studies.

Results

• They delineated seven randomized controlled trials and one open-label study (n = 3,097).
• Moreover, treatments included combinations of several ICIs, a combination of an ICI and dacarbazine, two combinations of an ICI, paclitaxel, and carboplatin, and a combination of an ICI and gp100 vaccine.
• As compared to monotherapy, they found higher ORR (RR: 1.51, 95% CI: 1.03–2.20, p = 0.034), OS (HR: 0.86, 95% CI: 0.78–0.95, p = 0.000), and PFS (HR: 0.93, 95% CI: 0.72–1.14, p = 0.000) values in combination therapy.
• It was observed that the toxicity of combination ICI immunotherapy was higher (RR: 1.50, 95% CI: 1.03–2.19, p = 0.036) than that of monotherapy.