Combination or single-agent ipilimumab as immunotherapy of advanced melanoma: a critical review

Aim: A pooled analysis of the efficacy and toxicity of combination immunotherapy versus single-agent ipilimumab in the management of advanced melanoma has been conducted. Methodology: Eligible studies included randomized controlled studies evaluating ipilimumab-based doublet immunotherapy versus ipilimumab monotherapy for the management of unresectable melanoma. Results: Nivolumab/ipilimumab combination strategy is associated with a significant improvement in objective response rate (odds ratio: 7.38; 95% CI: 3.71–14.67; p < 0.00001) and progression-free survival (0.42; 95% CI: 0.34–0.52; p < 0.00001) as well as a higher relative risk for high-grade elevated alanine aminotransferase (5.58; 95% CI: 2.28–13.67; p = 0.0002).  Conclusion: This analysis demonstrated that nivolumab/ipilimumab combination is associated with a higher objective response rate and progression-free survival in the management of advanced melanoma.