Wen Yanting, Meng Li, Zhang Xian, Gao Qian
Department of Basic Medicine, Center of Translational Medicine, Jiangsu Key Laboratory of Molecular Medicine, Nanjing University Medical School, Nanjing, Jiangsu, China.
Maternity Intensive Care Unit, Nanjing Maternity and Child Health Care Hospital, Women's Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.
Expert Rev Hematol. 2022 Sep;15(9):849-856. doi: 10.1080/17474086.2022.2110062. Epub 2022 Aug 9.
Phosphatidylinositol 3-kinase (PI3K) inhibitors demonstrate promising effects in the treatment of relapsed/refractory chronic lymphocytic leukemia (CLL). Emerging evidence of the therapeutic effects of the PI3K inhibitors in various aspects remains controversial.
This meta-analysis was used to evaluate the efficacy and safety of PI3K inhibitors based on a synthesis of the data generated by randomized controlled trials (RCTs) of patients with CLL, by searching PubMed, EMBASE, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov registry.
Five RCTs with 1593 patients were included. The PI3K inhibitors significantly improved progression-free survival (PFS), the chance of overall response, and partial response compared to the control arm. Regarding adverse events (AEs), the PI3K inhibitors increased the risk of pyrexia, chills, diarrhea, decreased appetite, vomiting, rash, pneumonia, and upper respiratory tract infection.
Available evidence showed significant improvements over conventional therapy in PFS of the PI3K inhibitors in patients with CLL, with relatively manageable AEs.
磷脂酰肌醇3-激酶（PI3K）抑制剂在复发/难治性慢性淋巴细胞白血病（CLL）的治疗中显示出有前景的效果。PI3K抑制剂在各方面治疗效果的新证据仍存在争议。
本荟萃分析通过检索PubMed、EMBASE、Cochrane对照试验中央注册库和ClinicalTrials.gov注册库，综合CLL患者随机对照试验（RCT）产生的数据，以评估PI3K抑制剂的疗效和安全性。
纳入了5项RCT，共1593例患者。与对照组相比，PI3K抑制剂显著改善了无进展生存期（PFS）、总体缓解机会和部分缓解。关于不良事件（AE），PI3K抑制剂增加了发热、寒战、腹泻、食欲减退、呕吐、皮疹、肺炎和上呼吸道感染的风险。
现有证据表明，PI3K抑制剂在CLL患者的PFS方面比传统疗法有显著改善，且不良事件相对可控。
