Dai Yun, Muaibati Munawaer, Xie Weiming, Abasi Abuduyilimu, Li Kexin, Tong Qing, Zhang Tao, Meng Yifan, Zhuang Liang, Huang Xiaoyuan
Department of Gynecological Oncology, Tongji Hospital of Huazhong University of Science and Technology, Wuhan, China.
Department of Traumatic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Cancer Invest. 2022 Mar;40(3):293-309. doi: 10.1080/07357907.2021.2012188. Epub 2021 Dec 9.
The efficacy of programmed cell death protein 1(PD-1)/Programmed cell death 1 ligand 1 (PD-L1) inhibitors for endometrial cancer remain controversial, and guidelines are inconsistent on which are preferred therapies for advanced disease, or who develop metastases and recurrence. Therefore, we aimed to estimate the efficacy and safety of PD-1/PD-L1 inhibitors in endometrial cancer on a more complete database by adding multiple randomized trials.
A systematic and comprehensive search was carried out in PD-1/PD-L1 inhibitors monotherapy.
The ORR of PD-1/PDL-1 inhibitors was 29%, and subgroup analysis showed that the pooled ORR of the proficient mismatch repair (pMMR) group was 4% and which was 45% of the deficient mismatch repair (dMMR) group. The DCR of PD-1/PD-L1 inhibitors was 48%, through subgroup analysis, we found that the DCR of the pMMR group was 21% and which was 58% of the dMMR group. The proportion of patients occurring overall adverse events was 65% and grade three or higher adverse events was 14%. The proficient mismatch repair (pMMR) group and the deficient mismatch repair (dMMR) group showed different results.
PD-1/PD-L1 inhibitors had shown little success in the pMMR population and better efficacy in the dMMR population.
程序性细胞死亡蛋白1（PD-1）/程序性细胞死亡蛋白1配体1（PD-L1）抑制剂治疗子宫内膜癌的疗效仍存在争议，对于晚期疾病或发生转移及复发的患者，哪种是首选治疗方法，指南也不一致。因此，我们旨在通过纳入多项随机试验，在更完整的数据库上评估PD-1/PD-L1抑制剂治疗子宫内膜癌的疗效和安全性。
对PD-1/PD-L1抑制剂单药治疗进行系统全面的检索。
PD-1/PD-L1抑制剂的客观缓解率（ORR）为29%，亚组分析显示，错配修复功能正常（pMMR）组的汇总ORR为4%，而错配修复缺陷（dMMR）组为45%。PD-1/PD-L1抑制剂的疾病控制率（DCR）为48%，通过亚组分析，我们发现pMMR组的DCR为21%，而dMMR组为58%。发生总体不良事件的患者比例为65%，三级或更高级别不良事件为14%。错配修复功能正常（pMMR）组和错配修复缺陷（dMMR）组结果不同。
PD-1/PD-L1抑制剂在pMMR人群中疗效不佳，而在dMMR人群中疗效较好。
