Chen Yafang, Liu Xiaomei, Hu Ying, Xia Lingling
Oncology Department Three Wards, The First Affiliated Hospital of Army Medical University, Chongqing, China.
Medicine (Baltimore). 2024 May 3;103(18):e38019. doi: 10.1097/MD.0000000000038019.
Recurrent ovarian cancer (OC) presents a significant therapeutic challenge with limited treatment success. Programmed cell death protein 1 (PD-1/PD-L1) immune checkpoint inhibitors have emerged as a potential treatment avenue, necessitating a systematic review and meta-analysis to evaluate their efficacy and safety.
Adhering to preferred reporting items for systematic reviews and meta-analyses guidelines, we conducted a comprehensive literature search across PubMed, Embase, Web of Science, and Cochrane Library, culminating in the inclusion of studies focusing on the treatment of recurrent OC with PD-1/PD-L1 inhibitors. Studies were evaluated using the Newcastle-Ottawa Scale and analyzed using fixed or random effects models depending on heterogeneity levels.
Our search yielded 1215 articles, with 6 meeting the inclusion criteria for final analysis. Studies varied in size and reported median age, overall survival (OS), progression-free survival (PFS), and adverse events. The meta-analysis showed improved Objective Response Rates (ORR), Disease Control Rate (DCR), and PFS in patients treated with PD-1/PD-L1 inhibitors. The overall adverse event rate was 17.9%, indicating a need for careful patient selection and monitoring. No significant publication bias was detected, enhancing the reliability of our findings.
PD-1/PD-L1 inhibitors offer a promising treatment option for recurrent OC, improving ORR, DCR, and PFS. However, the higher incidence of adverse events necessitates a cautious approach to their use. Future research should focus on long-term outcomes, biomarker identification, and optimal combination therapies.
复发性卵巢癌(OC)带来了重大的治疗挑战,治疗成功率有限。程序性细胞死亡蛋白1(PD-1/PD-L1)免疫检查点抑制剂已成为一种潜在的治疗途径,因此需要进行系统评价和荟萃分析来评估其疗效和安全性。
按照系统评价和荟萃分析的首选报告项目指南,我们在PubMed、Embase、科学网和考克兰图书馆进行了全面的文献检索,最终纳入了聚焦于用PD-1/PD-L1抑制剂治疗复发性OC的研究。使用纽卡斯尔-渥太华量表对研究进行评估,并根据异质性水平使用固定效应模型或随机效应模型进行分析。
我们的检索得到1215篇文章,其中6篇符合最终分析的纳入标准。各研究规模不同,报告了中位年龄、总生存期(OS)、无进展生存期(PFS)和不良事件。荟萃分析显示,接受PD-1/PD-L1抑制剂治疗的患者客观缓解率(ORR)、疾病控制率(DCR)和PFS有所改善。总体不良事件发生率为17.9%,表明需要谨慎选择患者并进行监测。未检测到显著的发表偏倚,提高了我们研究结果的可靠性。
PD-1/PD-L1抑制剂为复发性OC提供了一种有前景的治疗选择,可改善ORR、DCR和PFS。然而,不良事件发生率较高,因此在使用时需要谨慎。未来的研究应关注长期结局、生物标志物识别和最佳联合治疗。