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铂耐药复发性卵巢癌的靶向药物治疗策略比较：贝叶斯网状Meta 分析。

Comparison of target agent treatment strategies for platinum-resistant recurrent ovarian cancer: A Bayesian network meta-analysis.

机构信息

Department of Obstetrics and Gynecology, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi, Taiwan.

Department of Radiation Oncology, An-Nan Hospital, China Medical University, Tainan, Taiwan.

出版信息

Medicine (Baltimore). 2024 May 24;103(21):e38183. doi: 10.1097/MD.0000000000038183.

DOI:10.1097/MD.0000000000038183
PMID:38788019
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11124750/
Abstract

BACKGROUND

We aimed to compare 7 newer immunotherapies and targeted therapies for platinum-resistant relapsed ovarian cancer.

METHODS

We conducted a comprehensive search of PubMed, EMBASE, and Cochrane Library electronic databases for phase III trials involving platinum-resistant recurrent ovarian cancer (PRrOC) patients treated with immunotherapy or targeted therapy in combination with chemotherapy. The quality of the included trials was assessed using the GRADE method. The primary outcome of comparison was progression-free survival, and secondary outcomes included overall survival and safety.

RESULTS

This analysis included 7 randomized phase III controlled trials, encompassing 2485 PRrOC patients. Combining bevacizumab plus chemotherapy and lurbinectedin demonstrated statistically significant differences in progression-free survival compared to all other regimens of interest. However, no statistically significant differences were observed in the overall survival. Nivolumab and mirvetuximab exhibited fewer serious adverse events than the other regimens of interest.

CONCLUSIONS

Our findings indicate that bevacizumab combined with chemotherapy and lurbinectedin monotherapy has significant efficacy in patients with PRrOC. For patients with PRrOC who have exhausted treatment options, nivolumab and mirvetuximab may be considered as alternatives because of their better safety profiles.

摘要

背景

我们旨在比较 7 种新型免疫疗法和靶向疗法在铂耐药复发性卵巢癌中的疗效。

方法

我们对 PubMed、EMBASE 和 Cochrane Library 电子数据库进行了全面检索，以查找纳入铂耐药复发性卵巢癌（PRrOC）患者接受免疫治疗或靶向治疗联合化疗的 III 期临床试验。使用 GRADE 方法评估纳入试验的质量。比较的主要结局是无进展生存期，次要结局包括总生存期和安全性。

结果

本分析纳入了 7 项随机 III 期对照试验，共纳入 2485 例 PRrOC 患者。贝伐珠单抗联合化疗和卢比尼替因与所有其他感兴趣的治疗方案相比，在无进展生存期方面具有统计学显著差异。然而，在总生存期方面没有观察到统计学显著差异。纳武单抗和 mirvetuximab 与其他感兴趣的治疗方案相比，严重不良事件发生率较低。

结论

我们的研究结果表明，贝伐珠单抗联合化疗和卢比尼替因单药治疗在铂耐药复发性卵巢癌患者中具有显著疗效。对于铂耐药复发性卵巢癌患者，已经用尽了治疗选择，纳武单抗和 mirvetuximab 可能因其更好的安全性而被视为替代方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9d03/11124750/ecf96b21865b/medi-103-e38183-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9d03/11124750/9f901a21e70b/medi-103-e38183-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9d03/11124750/d4dac4e5ff77/medi-103-e38183-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9d03/11124750/ecf96b21865b/medi-103-e38183-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9d03/11124750/9f901a21e70b/medi-103-e38183-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9d03/11124750/d4dac4e5ff77/medi-103-e38183-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9d03/11124750/ecf96b21865b/medi-103-e38183-g003.jpg

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本文引用的文献

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Pharm Res. 2024 Mar;41(3):419-440. doi: 10.1007/s11095-023-03649-z. Epub 2024 Feb 17.
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Safety and efficacy of mirvetuximab soravtansine, a folate receptor alpha (FRα)-targeting antibody-drug conjugate (ADC), in combination with bevacizumab in patients with platinum-resistant ovarian cancer.Mirvetuximab soravtansine（一种靶向叶酸受体α（FRα）的抗体药物偶联物（ADC））与贝伐单抗联合用于铂耐药卵巢癌患者的安全性和有效性。
Gynecol Oncol. 2023 Mar;170:241-247. doi: 10.1016/j.ygyno.2023.01.020. Epub 2023 Feb 1.
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Efficacy and Safety of Mirvetuximab Soravtansine in Patients With Platinum-Resistant Ovarian Cancer With High Folate Receptor Alpha Expression: Results From the SORAYA Study.
高叶酸受体α表达的铂耐药卵巢癌患者中 Mirvetuximab Soravtansine 的疗效和安全性：来自 SORAYA 研究的结果。
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