免疫检查点抑制剂联合治疗晚期肾细胞癌：随机对照试验的荟萃分析。
Combination therapy with immune checkpoint inhibitors in advanced renal cell carcinoma: A meta-analysis of randomized controlled trials.
机构信息
Radiotherapy Department, The Third Affiliated Hospital of Guangxi Medical University, Nanning 530000, Guangxi, China.
Radiotherapy Department, The Third Affiliated Hospital of Guangxi Medical University, Nanning 530000, Guangxi, China.
出版信息
Clin Immunol. 2021 Nov;232:108876. doi: 10.1016/j.clim.2021.108876. Epub 2021 Nov 2.
PURPOSE
To evaluate the efficacy and safety of immune checkpoint inhibitor combination therapy in advanced renal cell carcinoma (RCC).
METHODS
We searched PubMed/Embase/Cochrane Library for relevant randomized controlled trials (RCTs). Clinical outcome measures including overall survival (OS), progression-free survival (PFS), objective response rates (ORRs), and adverse events (AEs) were analyzed by Stata 15.1 software.
RESULTS
Seven RCTs involving 3461 patients were included. The pooled hazard ratios of OS and PFS for combination therapy were 0.67 (0.53-0.82, p < 0.001) and 0.68 (0.52-0.83, p < 0.001), respectively. Longer OS and PFS for combination therapy was also observed in the PD-L1 expression leve ≥1% group. The pooled odds ratios of ORRs and grade 3 or higher AEs were 2.31 (1.61-3.32, p < 0.001) and 0.94 (0.65-1.37, p = 0.753), respectively.
CONCLUSIONS
Immune checkpoint inhibitor combination therapy showed more clinical benefit in the first-line treatment for advanced RCC, with a safety profile.
目的
评估免疫检查点抑制剂联合治疗在晚期肾细胞癌（RCC）中的疗效和安全性。
方法
我们在 PubMed/Embase/Cochrane Library 中搜索了相关的随机对照试验（RCTs）。使用 Stata 15.1 软件分析了总生存期（OS）、无进展生存期（PFS）、客观缓解率（ORR）和不良反应（AE）等临床结局指标。
结果
纳入了 7 项 RCTs，共 3461 例患者。联合治疗的 OS 和 PFS 的合并风险比分别为 0.67（0.53-0.82，p<0.001）和 0.68（0.52-0.83，p<0.001）。在 PD-L1 表达水平≥1%的患者中，联合治疗的 OS 和 PFS 也更长。ORR 和 3 级或更高级别的 AE 的合并优势比分别为 2.31（1.61-3.32，p<0.001）和 0.94（0.65-1.37，p=0.753）。
结论
免疫检查点抑制剂联合治疗在晚期 RCC 的一线治疗中显示出了更多的临床获益，且安全性良好。
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