PD-1 与 PD-L1 抑制剂免疫相关性肺炎风险差异的meta 分析：根据新的镜像原则和 PRISMA 指南。
Differences in the risk of immune-related pneumonitis between PD-1 and PD-L1 inhibitors: a meta-analysis according to the new mirror-principle and PRISMA guidelines.
机构信息
Phase I Clinical Research Center, Shandong Cancer Hospital and Institute, Shandong First Medical University, and Shandong Academy of Medical Sciences, No. 440, Jiyan Road, Huaiyin District, Jinan City, 250117, Shandong, People's Republic of China.
Radiotherapy Department, Shandong Second Provincial General Hospital, Shandong University, Jinan, 250299, Shandong, People's Republic of China.
出版信息
Cancer Immunol Immunother. 2024 Jul 2;73(9):162. doi: 10.1007/s00262-024-03736-z.
PURPOSE
To compare the risk of immune-associated pneumonitis between PD-1 and PD-L1 inhibitors, the meta-analysis was designed.
METHOD
The difference in risk of immune-associated pneumonitis between PD-1 and PD-L1 inhibitors was assessed by two different meta-analysis methods, the Mirror-pairing and the PRISMA guidelines.
RESULTS
A total of eighty-eight reports were used for meta-analysis, while thirty-two studies were used for the Mirror-pairing. Both PD-1 and PD-L1 inhibitors (used alone or combined with chemotherapy) increased the risk of developing immune-related pneumonitis (P < 0.00001; P < 0.00001). Based on indirect analyses results (subgroup analyses), the risk of PD-L1-induced pneumonitis was weaker than that of PD-1 inhibitors when the control group was chemotherapy (OR = 3.33 vs. 5.43) or placebo (OR = 2.53 vs. 3.19), while no obvious significant differences were found (P = 0.17; P = 0.53). For the Mirror-pairing-based meta-analysis, the risk of PD-1-induced pneumonitis was significantly higher than that of PD-L1 inhibitors (OR = 1.46, 95%CI [1.08, 1.98], I = 0%, Z = 2.47 (P = 0.01)). However, this difference was not significant, when they were combined with chemotherapy (OR = 1.05, 95%CI [0.68, 1.60], I = 38%, Z = 0.21 (P = 0.84)).
CONCLUSION
Both PD-1 and PD-L1 inhibitors increased the risk of immune-related pneumonitis, while the risk of PD-1-induced pneumonitis was significantly higher than that of PD-L1 inhibitors.
目的
比较 PD-1 和 PD-L1 抑制剂引发免疫相关肺炎的风险，设计了本次荟萃分析。
方法
采用两种不同的荟萃分析方法，即镜像配对和 PRISMA 指南，评估 PD-1 和 PD-L1 抑制剂引发免疫相关肺炎风险的差异。
结果
共有 88 项报告用于荟萃分析，其中 32 项研究用于镜像配对。PD-1 和 PD-L1 抑制剂（单独使用或与化疗联合使用）均增加了发生免疫相关肺炎的风险（P<0.00001；P<0.00001）。基于间接分析结果（亚组分析），当对照组为化疗（OR=3.33 比 5.43）或安慰剂（OR=2.53 比 3.19）时，PD-L1 诱导性肺炎的风险弱于 PD-1 抑制剂，但差异无统计学意义（P=0.17；P=0.53）。对于基于镜像配对的荟萃分析，PD-1 诱导性肺炎的风险明显高于 PD-L1 抑制剂（OR=1.46，95%CI [1.08, 1.98]，I=0%，Z=2.47（P=0.01））。然而，当与化疗联合使用时，这种差异无统计学意义（OR=1.05，95%CI [0.68, 1.60]，I=38%，Z=0.21（P=0.84））。
结论
PD-1 和 PD-L1 抑制剂均增加了免疫相关肺炎的风险，而 PD-1 诱导性肺炎的风险明显高于 PD-L1 抑制剂。
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