Abstract
Objective: The research aimed to evaluate the synergistic effects of combining various immunotherapies for treating stage IV cancer. Specifically, the study sought to determine whether combination therapies could improve clinical outcomes, slow tumor progression, and increase overall survival rates in advanced cancer patients.
Methods: A prospective, randomized controlled trial was conducted at a tertiary care hospital in Pakistan, involving 100 patients diagnosed with stage IV cancer. The patients were randomly assigned into two groups: Group A (combination therapy) receiving Pembrolizumab (200 mg every 3 weeks) and Ipilimumab (3 mg/kg every 3 weeks), and Group B (monotherapy) receiving Pembrolizumab alone (200 mg every 3 weeks). Tumor response was assessed using RECIST 1.1 criteria, while progression-free survival (PFS) and overall survival (OS) were evaluated as primary and secondary endpoints, respectively. Adverse events were monitored using the CTCAE scale, and quality of life (QoL) was assessed using the EORTC QLQ-C30 questionnaire. Data were analyzed using Kaplan-Meier survival analysis and Cox proportional hazards models.
Results: The results revealed that combination immunotherapies significantly reduced tumor progression and improved survival rates compared to single-agent treatments. Patients receiving combination therapies exhibited a better response rate, with 45% showing a complete or partial response to the treatment, compared to 30% in the monotherapy group.
Conclusion: The study concluded that combining immunotherapies in stage IV cancer patients resulted in a synergistic effect, enhancing clinical outcomes and improving overall survival rates. The findings support the potential of combination therapies as a viable treatment option for advanced cancers, warranting further investigation.