Chemotherapy in focus: A meta-analysis confronts immunotherapy in the treatment of advanced melanoma

[Display omitted] •Relevant studies that compares immunotherapy and chemotherapy were involved in our analysis.•The 24-months overall survival showed statistical benefit on chemotherapy.•Both therapies are associated with important adverse effects.•The cost of moAb treatment limits the evidence of its benefits when considering replacing conventional therapy.•Combination therapy brings more benefits compared to monotherapy alone. This study aimed to analyze the efficacy of the monoclonal antibodies ipilimumab, nivolumab, and pembrolizumab when compared with conventional chemotherapy in the treatment of advanced melanoma. Three authors made the search independently and five articles matched the eligibility criteria. A fourth expert confirmed their quality (κ = 1). The meta-analysis for overall survival and 12-month overall survival was impaired due to remarkably high heterogeneity (I2 = 91 % and 86 %, respectively). However, chemotherapy showed benefits on 24-months overall survival (RR = 1.60; IC95 %: 1.29, 1.98; p