Wang Jiting, Su Song, Li Jun, Li Yaling
Department of Pharmacy, Southwest Medical University, Luzhou, China.
Department of Pharmacy, Affiliated Hospital of Southwest Medical University, Luzhou, China.
Front Oncol. 2021 Jun 25;11:695512. doi: 10.3389/fonc.2021.695512. eCollection 2021.
This meta-analysis compared the safety and efficacy of camrelizumab monotherapy and combination therapy, aiming to provide a reference for the clinical combined use of camrelizumab in the treatment of cancers and also provide a reference for the development of subsequent indications of camrelizumab.
Meta-analysis was used to analyze the four eligible literatures. Primary endpoints of effectiveness index were objective response rate (ORR), progression-free survival (PFS), control rate (CR). Primary endpoint of safety index was rating of severity of adverse drug reactions (grades 1-5).
The ORR, PFS, and CR values of combined treatment with camrelizumab was better than alone treatment, camrelizumab alone was better than chemotherapy (RR = 0.45; 95% CI, 0.30-0.67; P < 0.001; RR = 1.63; 95% CI, 1.25-2.13; P < 0.001; RR = 0.73; 95% CI, 0.52-1.02; P<0.001). When grade > 2, the incidence rate of combined treatment and chemotherapy are higher than monotherapy (RR = 0.66; 95% CI, 0.51-0.86; P<0.001). In any grade, the safety of camrelizumab combination therapy was better than that of monotherapy, the safety of chemotherapy was better than camrelizumab plus chemotherapy.
In terms of effectiveness, the combination of camrelizumab is better than monotherapy, and monotherapy is better than chemotherapy. In terms of safety, when the grade > 2, single use is better than combination therapy and chemotherapy. In any grade of adverse event, the safety of combined use of camrelizumab is better than that of single use, and the safety of chemotherapy is better than the combined use of camrelizumab plus chemotherapy.
本荟萃分析比较了卡瑞利珠单抗单药治疗与联合治疗的安全性和有效性，旨在为卡瑞利珠单抗在癌症治疗中的临床联合应用提供参考，也为卡瑞利珠单抗后续适应证的开发提供参考。
采用荟萃分析方法对4篇符合条件的文献进行分析。有效性指标的主要终点为客观缓解率（ORR）、无进展生存期（PFS）、控制率（CR）。安全性指标的主要终点为药物不良反应严重程度分级（1 - 5级）。
卡瑞利珠单抗联合治疗的ORR、PFS和CR值优于单药治疗，卡瑞利珠单抗单药治疗优于化疗（RR = 0.45；95%CI，0.30 - 0.67；P < 0.001；RR = 1.63；95%CI，1.25 - 2.13；P < 0.001；RR = 0.73；95%CI，0.52 - 1.02；P<0.001）。当分级>2级时，联合治疗与化疗的发生率高于单药治疗（RR = 0.66；95%CI，0.51 - 0.86；P<0.001）。在任何分级中，卡瑞利珠单抗联合治疗的安全性优于单药治疗，化疗的安全性优于卡瑞利珠单抗联合化疗。
在有效性方面，卡瑞利珠单抗联合治疗优于单药治疗，单药治疗优于化疗。在安全性方面，当分级>2级时，单药使用优于联合治疗和化疗。在任何等级的不良事件中，卡瑞利珠单抗联合使用的安全性优于单药使用，化疗的安全性优于卡瑞利珠单抗联合化疗。
