Efficacy of different types of melanoma vaccines to prevent recurrence after local resection: a systematic review and meta-analysis

Keywords

melanoma vaccines - resected melanoma - TLPLDC - TLPLDC+G - TLPO

Introduction: Melanoma recurrence rates remain high despite complete resection followed by adjuvant chemotherapy and immunotherapy. Different types of melanoma vaccines have emerged as complementary treatment to reduce recurrence. However, their effectiveness in preventing recurrence and improving survival remains debatable.

Objectives: To evaluate the efficacy of different melanoma vaccines (TLPLDC, TLPLDC+G, and TLPO) compared to standard treatment, determine their impact on Disease-Free Survival (DFS) and Overall Survival (OS), and provide quantitative evidence on the effectiveness of these vaccines through a meta-analysis.

Methods: We searched in Pubmed, Cochrane, and Embase in April 2024 for studies comparing different types of melanoma vaccines against standard treatment. Inclusion criteria were randomized controlled trials evaluating the effectiveness of tumor lysate, particle-loaded, dendritic cells (TLPLDC), TLPLDC+granulocyte-colony stimulating factor (G), and tumor lysate particle only (TLPO) vaccines against control on the recurrence and survival of patients with completely resected melanoma. Outcomes of interest included DFS and OS. Hazard ratios were pooled using random-effects models in R software version 4.3.2. Risk-of-bias assessment was conducted using RoB 2.

Results: We included 7 randomized controlled trials comprising 1,211 patients. At the 3-year follow-up, TLPLDC favored DFS over control (HR=0.66 [0.47,0.93], p = 0.02, I²=49%), although the 2-year follow-up was not statistically significant (HR=0.78,CI[0.59,1.03],p = 0.07,I²=0%). At 3 years follow-up, TLPLDC+G (HR=1.31,CI[0.93,1.84],p = 0.12,I²=0%) and TLPO (HR=0.71, CI[0.44,1.12],p = 0.14,I²=74%) were not statistically significant. TLPLDC showed improved OS at both 3-year (HR=0.18, CI[0.07,0.48], p<0.01, I² =0%) and 2-year follow-ups (HR=0.28,CI[0.12,0.67],p<0.01,I²=36%). TLPO at 36-months (HR=0.55,CI[0.29,1.03],p = 0.06,I²=35%) was not significant, while at 24-months (HR=0.41, CI[0.21,0.82],p = 0.01,I²=0%) it was significant. TLPLDC+G could only be analyzed at the 3-year follow-up, showing no difference (HR=1.04,CI[0.6,1.8],p = 0.88,I²=0%).

Conclusion: TLPLDC vaccines consistently improved DFS and OS in the 3-year follow-up analysis. Therefore, TLPLDC vaccines could be an effective addition to resectable melanoma treatment.

Corresponding author: Rafael Morriello (e-mail: [e-mail]).

 

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No conflict of interest has been declared by the author(s).

Publication History

Article published online:
06 May 2025