免疫检查点抑制剂联合用药作为晚期尿路上皮癌患者一线全身治疗的疗效：一项系统评价和网状Meta分析
Efficacy of immune checkpoint inhibitors combinations as first-line systemic treatment in patients with advanced urothelial carcinoma: A systematic review and network meta-analysis.
作者信息
Monteiro Fernando Sabino Marques, Soares Andrey, Mollica Veronica, Leite Caio Abner, Carneiro Andre Paterno Castello Dias, Rizzo Alessandro, Bourlon Maria T, Sasse Andre Deeke, Santoni Matteo, Gupta Shilpa, Massari Francesco
机构信息
Oncology and Hematology Department, Hospital Sirio Libanês, Brasilia, DF 70200-300, Brazil; School of Medicine, Pontificia Universidade Católica do Rio Grande do Sul - PUCRS, Porto Alegre, RS 90619-900, Brazil; Genito-Urinary Tumors Department, Latin American Cooperative Oncology Group - LACOG, Porto Alegre, RS 90619-900, Brazil.
Genito-Urinary Tumors Department, Latin American Cooperative Oncology Group - LACOG, Porto Alegre, RS 90619-900, Brazil; Oncology and Hematology Department, Hospital Israelita Albert Einstein, São Paulo, SP 05653-120, Brazil.
出版信息
Crit Rev Oncol Hematol. 2024 Apr;196:104321. doi: 10.1016/j.critrevonc.2024.104321. Epub 2024 Mar 7.
BACKGROUND
Combinations of immune checkpoint inhibitors (ICI) with platinum-based chemotherapy (PlatinumCT) or with another ICI in the first-line setting for patients with metastatic urothelial carcinoma (mUC) have mixed results.
METHODS
Records were searched electronically from January 2019 to January 2024. A meta-analysis was performed to evaluate OS, progression-free survival (PFS), and overall response rate (ORR).
RESULTS
Immune-based combinations were associated with an OS (HR: 0.75; 95% CI: 0.61-0.92; p < 0.001; I2= 84.1%) and PFS benefit in the intention-to-treat population (HR: 0.67; 95%CI: 0.51-0.89; p < 0.001; I2 = 89.7%). There was no ORR improvement with immune-based combinations (HR: 1.36; 95% CI:0.84-2.20; p < 0.001; I2 = 92.6%).
CONCLUSION
This systematic review and study-level meta-analysis demonstrated that the immune-based combinations in first-line treatment for patients with mUC are associated with survival benefit.
背景
对于转移性尿路上皮癌（mUC）患者，免疫检查点抑制剂（ICI）与铂类化疗（铂类CT）联合或与另一种ICI在一线治疗中的疗效不一。
方法
通过电子检索2019年1月至2024年1月的记录。进行荟萃分析以评估总生存期（OS）、无进展生存期（PFS）和总缓解率（ORR）。
结果
在意向性治疗人群中，基于免疫的联合治疗与总生存期获益相关（风险比：0.75；95%置信区间：0.61 - 0.92；p < 0.001；I² = 84.1%）和无进展生存期获益（风险比：0.67；95%置信区间：0.51 - 0.89；p < 0.001；I² = 89.7%）。基于免疫的联合治疗未改善总缓解率（风险比：1.36；95%置信区间：0.84 - 2.20；p < 0.001；I² = 92.6%）。
结论
这项系统评价和研究水平的荟萃分析表明，mUC患者一线治疗中基于免疫的联合治疗与生存获益相关。
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