检查点抑制剂联合化疗用于晚期非小细胞肺癌一线治疗：一项随机对照试验的系统评价和荟萃分析

Checkpoint inhibitors plus chemotherapy for first-line treatment of advanced non-small cell lung cancer: a systematic review and meta-analysis of randomized controlled trials.

作者信息

Tun Aung Myint, Thein Kyaw Zin, Thein Wai Lin, Guevara Elizabeth

机构信息

Department of Medicine, Division of Hematology & Oncology, The Brooklyn Hospital Center, Brooklyn, NY 11201, USA.

Department of Hematology & Oncology, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA.

出版信息

Future Sci OA. 2019 Sep 25;5(9):FSO421. doi: 10.2144/fsoa-2019-0081.

BACKGROUND

We conducted a meta-analysis to evaluate the efficacy and safety of upfront add-on immunotherapy for advanced non-small cell lung cancers (NSCLC).

METHODS

We performed a literature search on first-line chemotherapy ± immunotherapy in NSCLC. We utilized Revman version 5.3 to calculate the estimated pooled hazard ratio for overall survival (OS) and progression-free survival (PFS) and pooled risk ratio for objective response rate (ORR), all-grade and high-grade adverse events with 95% CI.

RESULTS

We analyzed 4322 patients. The pooled hazard ratios for OS, PFS and ORR were 0.74 (95% CI: 0.62-0.88; p = 0.0007), 0.62 (95% CI: 0.57-0.68; p = 0.00001) and 1.51 (95% CI: 1.3-1.74; p = 0.00001), respectively. The pooled risk ratios for all-grade and high-grade adverse events were 1.01 (95% CI: 0.99-1.03; p = 0.27) and 1.17 (95% CI: 1.07-1.28; p = 0.0006), respectively.

CONCLUSION

Add-on immunotherapy significantly improves PFS, OS and ORR for the first-line treatment of advanced NSCLC with a reasonable safety profile.

背景

我们进行了一项荟萃分析，以评估一线附加免疫疗法治疗晚期非小细胞肺癌（NSCLC）的疗效和安全性。

方法

我们对NSCLC的一线化疗±免疫疗法进行了文献检索。我们使用Revman 5.3版来计算总生存期（OS）和无进展生存期（PFS）的估计合并风险比，以及客观缓解率（ORR）、所有级别和高级别不良事件的合并风险比，并给出95%置信区间。

结果

我们分析了4322例患者。OS、PFS和ORR的合并风险比分别为0.74（95%CI：0.62 - 0.88；p = 0.0007）、0.62（95%CI：0.57 - 0.68；p = 0.00001）和1.51（95%CI：1.3 - 1.74；p = 0.00001）。所有级别和高级别不良事件的合并风险比分别为1.01（95%CI：0.99 - 1.03；p = 0.27）和1.17（95%CI：1.07 - 1.28；p = 0.0006）。