免疫检查点抑制剂作为晚期或转移性癌症维持治疗的疗效：一项随机对照试验的荟萃分析。
Efficacy of immune checkpoint inhibitor as maintenance therapy for advanced or metastatic cancers: A meta-analysis of randomized controlled trials.
机构信息
Radiotherapy Department, The Third Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.
出版信息
Medicine (Baltimore). 2022 Sep 23;101(38):e30830. doi: 10.1097/MD.0000000000030830.
BACKGROUND
This study aimed to evaluate the efficacy of immune checkpoint inhibitors (ICIs) as maintenance therapy for advanced or metastatic cancers.
METHODS
The PubMed, Embase, and Cochrane Library databases were searched for eligible randomized controlled trials. A meta-analysis of eligible studies investigating the outcomes including progression-free survival (PFS), overall survival (OS), and objective response rate (ORR) with a significance level set to 0.05 was performed.
RESULTS
Five RCTs (n = 2828) were identified in this analysis. The pooled hazard ratios (HRs) of PFS and OS for ICI maintenance therapy were 0.88 (95% CI: 0.68-1.13, P = .31) and 0.82 (95% confidence interval [CI]: 0.74-0.92, P = .0005), respectively; the pooled odds ratio (OR) of ORR was 2.24 (95% CI: 1.23-4.09, P = .0008). Subgroup analysis indicated that anti-PD-L1 antibody significantly improved the OS (P = .0008), while anti-PD-1 and anti-PD-1 plus anti-cytotoxic T lymphocyte antigen 4 antibodies significantly prolonged the PFS of patients.
CONCLUSION
ICI maintenance therapy enhanced the survival of patients with advanced or metastatic cancers.
背景
本研究旨在评估免疫检查点抑制剂 (ICI) 作为晚期或转移性癌症维持治疗的疗效。
方法
检索了 PubMed、Embase 和 Cochrane Library 数据库中符合条件的随机对照试验。对纳入的研究进行了结局（无进展生存期 (PFS)、总生存期 (OS) 和客观缓解率 (ORR)）的荟萃分析，置信区间设为 95%，显著性水平为 0.05。
结果
本分析共纳入 5 项 RCT（n=2828）。ICI 维持治疗的 PFS 和 OS 的合并风险比 (HR) 分别为 0.88（95%CI：0.68-1.13，P=0.31）和 0.82（95%置信区间 [CI]：0.74-0.92，P=0.0005）；ORR 的合并优势比 (OR) 为 2.24（95%CI：1.23-4.09，P=0.0008）。亚组分析表明，抗 PD-L1 抗体显著改善了 OS（P=0.0008），而抗 PD-1 和抗 PD-1 联合抗细胞毒性 T 淋巴细胞相关抗原 4 抗体显著延长了患者的 PFS。
结论
ICI 维持治疗可提高晚期或转移性癌症患者的生存率。
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