联合免疫疗法治疗恶性实体瘤的疗效和安全性：系统评价和荟萃分析。
Efficacy and safety of combination immunotherapy for malignant solid tumors: A systematic review and meta-analysis.
机构信息
Department of Oncology, Capital Medical University Affiliated Beijing Friendship Hospital, Beijing, 100050, China.
Gastroenterology Department, Jincheng People's Hospital, Jincheng, 048000, China.
出版信息
Crit Rev Oncol Hematol. 2019 Jun;138:178-189. doi: 10.1016/j.critrevonc.2019.04.008. Epub 2019 Apr 15.
BACKGROUND
Combination immunotherapy has become an actively growing field of clinical investigation.
METHODS
We searched for clinical trials of combination immunotherapy and calculated the pooled hazard ratio (HR), odds ratio (OR) of clinical outcomes and safety by subgroups of different combination regimens.
RESULTS
Totally 28 clinical trials were analyzed. The study showed that the pooled HRs of overall survival and progression-free survival for combination therapy were 0.77 (95% CI: 0.70-0.84, p < 0.001) and 0.72 (95% CI: 0.66-0.79, p < 0.001) while the pooled OR of high-grade adverse effects was 1.45 (p = 0.004). Subgroup analysis showed that the HR of overal survival were 0.74 (p = 0.005), 0.79 (p < 0.001), 0.70 (p = 0.003) and 0.85 (p = 0.052) for immunotherapy combined with immunotherapy, chemotherapy, targeted therapy and radiotherapy group, respectively.
CONCLUSIONS
The meta-analysis indicated that combination immunotherapy could bring more clinical benefits with increased high-grade adverse effects.
背景
联合免疫疗法已成为临床研究中一个快速发展的领域。
方法
我们检索了联合免疫疗法的临床试验，并按不同联合方案的亚组计算了临床结局和安全性的合并风险比（HR）和优势比（OR）。
结果
共分析了 28 项临床试验。研究表明，联合治疗的总生存和无进展生存的合并 HR 分别为 0.77（95%CI：0.70-0.84，p<0.001）和 0.72（95%CI：0.66-0.79，p<0.001），而高级别不良事件的合并 OR 为 1.45（p=0.004）。亚组分析显示，免疫治疗联合免疫治疗、化疗、靶向治疗和放疗组的总生存 HR 分别为 0.74（p=0.005）、0.79（p<0.001）、0.70（p=0.003）和 0.85（p=0.052）。
结论
荟萃分析表明，联合免疫疗法可能带来更多的临床获益，但同时也增加了高级别不良事件的风险。
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