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度伐利尤单抗和曲美木单抗联合疗法与度伐利尤单抗或曲美木单抗单药疗法治疗实体瘤患者的疗效比较:一项系统评价和荟萃分析

Durvalumab and tremelimumab combination therapy versus durvalumab or tremelimumab monotherapy for patients with solid tumors: A systematic review and meta-analysis.

作者信息

Wang Bi-Cheng, Li Peng-Cheng, Fan Ji-Quan, Lin Guo-He, Liu Quentin

机构信息

Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan.

Department of Oncology, the Second Affiliated Hospital of Anhui Medical University, Hefei.

出版信息

Medicine (Baltimore). 2020 Jul 10;99(28):e21273. doi: 10.1097/MD.0000000000021273.

Abstract

BACKGROUND

The combination of durvalumab and tremelimumab results in clinical benefit, with a tolerable safety profile in patients with solid tumors.

OBJECTIVE

To evaluate the efficacy and safety of durvalumab in combination with tremelimumab compared with either drug alone.

METHODS

The online databases (PubMed, Web of Science, EMBASE, and Cochrane Library) were searched for potential clinical studies up to Nov 26, 2019. Eligible studies were prospective and registered clinical trials. Pooled odds ratios for objective response rate and disease control rate and pooled risk ratios for treatment-related adverse events were meta-analyzed. A random-effect model was used due to the synthesis of different cancer types.

RESULTS

Overall, 5 studies were eligible for systematic review, 3 of which were further meta-analyzed. Durvalumab plus tremelimumab was superior to tremelimumab monotherapy in improving disease control rate in head and neck squamous cell carcinoma. However, there were no significant differences between dual immunotherapy and mono-immunotherapy in pancreatic ductal adenocarcinoma and gastric and gastroesophageal junction adenocarcinoma. Additionally, pooled analyses illustrated that no significant differences in treatment-related adverse events were displayed between the 2 groups.

CONCLUSION

Durvalumab and tremelimumab combination therapy had a good safety profile and resulted in clinical benefit in head and neck squamous cell carcinoma. Future explorations are needed to further confirm the application of durvalumab plus tremelimumab.

摘要

背景

度伐利尤单抗与曲美木单抗联合使用可带来临床获益,在实体瘤患者中具有可耐受的安全性。

目的

评估度伐利尤单抗与曲美木单抗联合使用相较于单药治疗的疗效和安全性。

方法

检索在线数据库(PubMed、Web of Science、EMBASE和Cochrane图书馆),查找截至2019年11月26日的潜在临床研究。符合条件的研究为前瞻性注册临床试验。对客观缓解率和疾病控制率的合并比值比以及治疗相关不良事件的合并风险比进行荟萃分析。由于纳入了不同癌症类型,采用随机效应模型。

结果

总体而言,5项研究符合系统评价条件,其中3项进一步进行了荟萃分析。在改善头颈部鳞状细胞癌的疾病控制率方面,度伐利尤单抗联合曲美木单抗优于曲美木单抗单药治疗。然而,在胰腺导管腺癌以及胃和胃食管交界腺癌中,双免疫疗法与单免疫疗法之间无显著差异。此外,汇总分析表明,两组在治疗相关不良事件方面无显著差异。

结论

度伐利尤单抗与曲美木单抗联合治疗具有良好的安全性,对头颈部鳞状细胞癌有临床获益。需要进一步探索以进一步证实度伐利尤单抗联合曲美木单抗的应用。

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