Petrelli Fausto, Ferrara Roberto, Signorelli Diego, Ghidini Antonio, Proto Claudia, Roudi Raheleh, Sabet Mehrdad N, Facelli Sara, Garassino Marina C, Luciani Andrea, Roviello Giandomenico
Medical Oncology Unit, ASST Bergamo ovest, 24047 Treviglio (BG), Italy.
Department of Medical Oncology, Thoracic Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italia.
Immunotherapy. 2021 May;13(7):621-631. doi: 10.2217/imt-2020-0224. Epub 2021 Mar 29.
This study is a meta-analysis of randomized controlled trials involving first-line studies in which immune checkpoint inhibitors were added to chemotherapy and were compared with chemotherapy alone. The primary end point was overall survival (OS). The analyses used random-effects models and the Grading of Recommendations Assessment, Development, and Evaluation system to rate the quality of the evidence. Nine articles were included for qualitative and quantitative synthesis. A meta-analysis of the nine randomized trials showed a significant benefit in terms of OS (hazard ratio: 0.75 [95% CI: 0.66-0.85]; p < 0.01). Only programmed death ligand-1 positive-high cancers derive a significant OS benefit. In this meta-analysis, there is moderate evidence that the addition of immune checkpoint inhibitors to chemotherapy may improve both OS compared with chemotherapy alone.
本研究是一项对随机对照试验的荟萃分析,这些试验涉及一线研究,其中将免疫检查点抑制剂添加到化疗中,并与单纯化疗进行比较。主要终点是总生存期(OS)。分析采用随机效应模型和推荐分级评估、制定与评价系统对证据质量进行评级。纳入9篇文章进行定性和定量综合分析。对这9项随机试验的荟萃分析显示,在总生存期方面有显著益处(风险比:0.75[95%CI:0.66-0.85];p<0.01)。只有程序性死亡配体-1高表达的癌症患者在总生存期方面有显著益处。在这项荟萃分析中,有中等证据表明,与单纯化疗相比,在化疗中添加免疫检查点抑制剂可能会改善总生存期。