肝转移对免疫治疗联合化疗治疗晚期肺癌疗效的影响。
The effect of liver metastasis on efficacy of immunotherapy plus chemotherapy in advanced lung cancer.
机构信息
Department of Medical Oncology, Changzheng Hospital, Second Military Medical University, Shanghai, 200072 China.
Department of Medical Oncology, Changzheng Hospital, Second Military Medical University, Shanghai, 200072 China.
出版信息
Crit Rev Oncol Hematol. 2020 Mar;147:102893. doi: 10.1016/j.critrevonc.2020.102893. Epub 2020 Jan 30.
The present study aimed to evaluate the effect of liver metastases on the efficacy from the combination of PD-1/PD-L1 inhibitor with chemotherapy as first-line treatment in lung cancer using the meta-analysis. A total of 8 randomized controlled trials (RCTs) were included. In patients without liver metastases, PD-1/PD-L1 inhibitor plus chemotherapy could decrease the risk of progression by 40% and risk of death by 29% (HR = 0.60; 95%CI,0.55- 0.65 and HR = 0.71;95%CI,0.58-0.90 respectively). In patients with liver metastases, PD-1/PD-L1 inhibitor plus chemotherapy could decrease the risk of progression by 31% and risk of death by 21% (HR = 0.69;95%CI,0.58-0.81; and HR = 0.79; 95%CI,0.62-0.80, respectively). The pooled ratios of PFS-HRs and OS- HRs reported in lung cancer patients with liver metastases versus those without liver metastases were 1.11 (95%CI, 0.92-1.34) and 1.03 (95%CI, 0.80-1.35), respectively, suggesting that lung cancer patients with and without liver metastases could obtain comparable efficacy.
本研究旨在通过荟萃分析评估 PD-1/PD-L1 抑制剂联合化疗作为一线治疗肺癌时肝转移对疗效的影响。共纳入 8 项随机对照试验（RCT）。在无肝转移的患者中，PD-1/PD-L1 抑制剂联合化疗可使进展风险降低 40%，死亡风险降低 29%（HR=0.60；95%CI，0.55-0.65 和 HR=0.71；95%CI，0.58-0.90）。在有肝转移的患者中，PD-1/PD-L1 抑制剂联合化疗可使进展风险降低 31%，死亡风险降低 21%（HR=0.69；95%CI，0.58-0.81；HR=0.79；95%CI，0.62-0.80）。有肝转移和无肝转移的肺癌患者的 PFS-HR 和 OS-HR 的汇总比值分别为 1.11（95%CI，0.92-1.34）和 1.03（95%CI，0.80-1.35），提示有和无肝转移的肺癌患者可获得相似的疗效。
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