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培美曲塞联合贝伐珠单抗治疗非小细胞肺癌的 Meta 分析研究。

Combination of pemetrexed with bevacizumab for non-small-cell lung cancer: a meta-analysis study.

机构信息

Department of Respiratory, Nan'an District People's Hospital, Chongqing, 400060, China.

Comprehensive Cancer Center, Daping Hospital, Army Medical University, No. 10 Daping Changjiang branch Road, Yuzhong District, Chongqing, 400042, China.

出版信息

J Cardiothorac Surg. 2024 Aug 2;19(1):478. doi: 10.1186/s13019-024-02975-6.

Abstract

BACKGROUND

Combining pemetrexed with bevacizumab may have some potential in improving the efficacy in patients with non-small-cell lung cancer (NSCLC), and this meta-analysis aims to explore the impact of pemetrexed addition to bevacizumab on treatment efficacy for NSCLC.

METHODS

PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases were systematically searched, and we included randomized controlled trials (RCTs) assessing the effect of pemetrexed addition to bevacizumab on treatment efficacy in patients with NSCLC. Overall survival and progression-free survival were included in this meta-analysis.

RESULTS

Four RCTs were finally included in the meta-analysis. Overall, compared with bevacizumab for NSCLC, pemetrexed addition showed significantly improved overall survival (hazard ratio [HR] = 0.87; 95% confidence interval [CI] = 0.76 to 0.99; P = 0.03), survival rate (odd ratio [OR] = 1.41; 95% CI = 1.06 to 1.86; P = 0.02), progression-free survival (HR = 0.63; 95% CI = 0.55 to 0.72; P < 0.00001) and progression-free survival rate (OR = 1.92; 95% CI = 1.38 to 2.67; P < 0.00001), but led to the increase in grade ≥ 3 adverse events (OR = 2.15; 95% CI = 1.62 to 2.84; P < 0.00001).

CONCLUSIONS

Pemetrexed addition may be effective to improve treatment efficacy for NSCLC compared to bevacizumab treatment.

摘要

背景

培美曲塞联合贝伐珠单抗治疗非小细胞肺癌(NSCLC)可能具有一定的增效作用,本 meta 分析旨在探讨培美曲塞联合贝伐珠单抗对 NSCLC 患者的疗效影响。

方法

系统检索 PubMed、EMbase、Web of science、EBSCO 和 Cochrane library 数据库,纳入评估培美曲塞联合贝伐珠单抗对比贝伐珠单抗治疗 NSCLC 患者的疗效的随机对照试验(RCT)。本 meta 分析纳入总生存期和无进展生存期。

结果

最终纳入 4 项 RCT。与贝伐珠单抗相比,培美曲塞联合贝伐珠单抗显著提高了总生存期(风险比 [HR] = 0.87;95%置信区间 [CI] = 0.76 至 0.99;P = 0.03)、生存率(比值比 [OR] = 1.41;95% CI = 1.06 至 1.86;P = 0.02)、无进展生存期(HR = 0.63;95% CI = 0.55 至 0.72;P < 0.00001)和无进展生存率(OR = 1.92;95% CI = 1.38 至 2.67;P < 0.00001),但导致 3 级及以上不良事件发生率增加(OR = 2.15;95% CI = 1.62 至 2.84;P < 0.00001)。

结论

与贝伐珠单抗相比,培美曲塞联合贝伐珠单抗可能更有效地提高 NSCLC 患者的疗效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/af82/11295867/5a6f7575a6d7/13019_2024_2975_Fig1_HTML.jpg

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