Experimental Center, Shandong University of Traditional Chinese Medicine, Jinan 250355, China.
Department of Oncology, Shandong Provincial Maternal and Child Health Care Hospital, Jinan 250014, China.
Oral Oncol. 2022 Dec;135:106231. doi: 10.1016/j.oraloncology.2022.106231. Epub 2022 Oct 31.
Molecular targeted therapies against vascular endothelial growth factor (VEGF) receptor (VEGFR) have been explored in the treatment of recurrent or metastatic nasopharyngeal carcinoma (rmNPC). We conducted a meta-analysis to evaluate the efficacy and safety of VEGF/VEGFR inhibitors for treating rmNPC.
Electronic databases were searched for eligible literature. Data on the objective response rate (ORR), disease control rate (DCR), median progression-free survival (mPFS), median overall survival (mOS), PFS rate, OS rate, and drug-related adverse events (AEs) were extracted.
A total of 10 studies (published in 9 articles) that involved 357 patients were included. The pooled ORR was 37 % (95 % confidence interval [CI]: 17-60 %), the DCR was 70 % (95 % CI: 51-85 %), the mPFS was 5.69 months (95 % CI: 4.52-6.86), the mOS was 12.61 months (95 % CI: 10.23-14.99), the 1-year PFS rate was 34 % (95 % CI: 25-44 %), and the 1-year OS rate was 62 % (95 % CI: 38-83 %). The pooled incidence of grade 3/4 drug-related AEs was 27 %, while that of grade 5 AEs was 0.22 %. Further subgroup analysis showed that the pooled ORR and DCR for first-line VEGF inhibitors were 80 % (95 % CI: 74-86 %) and 94 % (CI: 82-100 %), respectively.
Our meta-analysis is the first report to demonstrate the efficacy and safety of VEGF/VEGFR inhibitors in patients with rmNPC. Targeting VEGF/VEGFR therapy added to first-line chemotherapy achieved an excellent ORR and DCR, while the improvement in response rates did not translate to a prominent OS benefit.
针对血管内皮生长因子受体 (VEGFR) 的分子靶向治疗已被应用于复发性或转移性鼻咽癌（rmNPC）的治疗。我们进行了一项荟萃分析，以评估 VEGF/VEGFR 抑制剂治疗 rmNPC 的疗效和安全性。
电子数据库中检索到符合条件的文献。提取客观缓解率（ORR）、疾病控制率（DCR）、中位无进展生存期（mPFS）、中位总生存期（mOS）、PFS 率、OS 率和药物相关不良事件（AEs）的数据。
共纳入 10 项研究（发表于 9 篇文章），涉及 357 例患者。汇总的 ORR 为 37%（95%CI：17-60%），DCR 为 70%（95%CI：51-85%），mPFS 为 5.69 个月（95%CI：4.52-6.86），mOS 为 12.61 个月（95%CI：10.23-14.99），1 年 PFS 率为 34%（95%CI：25-44%），1 年 OS 率为 62%（95%CI：38-83%）。药物相关 3/4 级不良事件的发生率为 27%，5 级不良事件的发生率为 0.22%。进一步的亚组分析表明，一线 VEGF 抑制剂的汇总 ORR 和 DCR 分别为 80%（95%CI：74-86%）和 94%（CI：82-100%）。
本荟萃分析首次报道了 VEGF/VEGFR 抑制剂在复发性 NPC 患者中的疗效和安全性。针对 VEGF/VEGFR 的靶向治疗联合一线化疗可获得优异的 ORR 和 DCR，但反应率的提高并未带来明显的 OS 获益。
