Department of Medicine, Fatima Jinnah Medical University, Queen's Road, Mozang Chungi, Lahore, Pakistan.
The Aga Khan University, Karachi, Pakistan.
J Gastrointest Cancer. 2024 Sep;55(3):1026-1057. doi: 10.1007/s12029-024-01078-8. Epub 2024 Jul 8.
Pancreatic cancer remains a lethal malignancy with a 5-year survival rate below 6% and about 500,000 deaths annually worldwide. Pancreatic adenocarcinoma, the most prevalent form, is commonly associated with diabetes, chronic pancreatitis, obesity, and smoking, mainly affecting individuals aged 60 to 80 years. This systematic review aims to evaluate the efficacy of immunotherapeutic approaches in the treatment of pancreatic cancer.
A systematic search was conducted to identify clinical trials (Phases I-III) assessing immunotherapy in pancreatic cancer in PubMed/Medline, CINAHL, Scopus, and Web of Science, adhering to PRISMA Statement 2020 guidelines. The final search was completed on May 25, 2024. Ongoing trials were sourced from ClinicalTrials.gov and the World Health Organization's International Clinical Trials Registry Platform (ICTRP). Keywords such as "pancreatic," "immunotherapy," "cancer," and "clinical trial" were used across databases. Gray literature was excluded.
Phase I trials, involving 337 patients, reported a median overall survival (OS) of 13.6 months (IQR: 5-62.5 months) and a median progression-free survival (PFS) of 5.1 months (IQR: 1.9-11.7 months). Phase II/III trials pooled in a total of 1463 participants had a median OS of 12.2 months (IQR: 2.5-35.55 months) and a median PFS of 8.8 months (IQR: 1.4-33.51 months).
Immunotherapy shows potential for extending survival among pancreatic cancer patients, though results vary. The immunosuppressive nature of the tumor microenvironment and diverse patient responses underline the need for further research to optimize these therapeutic strategies.
胰腺癌仍然是一种致命的恶性肿瘤，全球每年有 50 万人死亡，5 年生存率低于 6%。最常见的胰腺腺癌通常与糖尿病、慢性胰腺炎、肥胖和吸烟有关，主要影响 60 至 80 岁的人群。本系统评价旨在评估免疫治疗方法在胰腺癌治疗中的疗效。
按照 PRISMA 声明 2020 指南，在 PubMed/Medline、CINAHL、Scopus 和 Web of Science 中进行系统搜索，以确定评估胰腺癌免疫治疗的临床试验（I-III 期）。最后一次搜索于 2024 年 5 月 25 日完成。正在进行的试验来自 ClinicalTrials.gov 和世界卫生组织国际临床试验注册平台（ICTRP）。数据库中使用了“胰腺”、“免疫疗法”、“癌症”和“临床试验”等关键词。排除灰色文献。
涉及 337 名患者的 I 期试验报告中位总生存期（OS）为 13.6 个月（IQR：5-62.5 个月），中位无进展生存期（PFS）为 5.1 个月（IQR：1.9-11.7 个月）。共有 1463 名参与者的 II/III 期试验汇总的中位 OS 为 12.2 个月（IQR：2.5-35.55 个月），中位 PFS 为 8.8 个月（IQR：1.4-33.51 个月）。
免疫疗法显示出延长胰腺癌患者生存的潜力，但结果各不相同。肿瘤微环境的免疫抑制性质和不同患者的反应强调需要进一步研究以优化这些治疗策略。
