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抗体药物偶联物和免疫检查点抑制剂在癌症治疗中的应用:系统评价和荟萃分析。

Antibody-drug conjugates and immune checkpoint inhibitors in cancer treatment: a systematic review and meta-analysis.

机构信息

Hangzhou TCM Hospital of Zhejiang Chinese Medical University (Hangzhou Hospital of Traditional Chinese Medicine), Hangzhou, China.

The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, China.

出版信息

Sci Rep. 2024 Sep 27;14(1):22357. doi: 10.1038/s41598-024-68311-z.

Abstract

Although antibody-drug conjugate (ADC) or immune checkpoint inhibitors (ICIs) alone fosters hope for the treatment of cancer, the effect of single drug treatment is limited and the safety profile of ADC and ICI therapy remains unclear. This meta-analysis aimed to examine the efficacy and safety of the combination of ADC and ICI therapy. This study type is a systematic review and meta-analysis. Literature retrieval was carried out through PubMed, Embase, Cochrane from inception to Jun. 5, 2024. Then, after data extraction, overall response rate (ORR) and adverse effects (AEs) were used to study its efficiency and safety. Publication bias was also calculated through Funnel plot, Begg's Test and Egger's test. Heterogeneity was investigated through subgroup and sensitivity analysis. The research protocol was registered with the PROSPERO (CRD42023375601). A total of 12 eligible clinical studies with 584 patients were included. The pooled ORR was 58% (95%CI 46%, 70%). Subgroup analysis showed an ORR of 77% (95%CI 63%, 91%) in classical Hodgkin lymphoma (cHL) and an ORR of 73% (95%CI 56%, 90%) in non-Hodgkin lymphoma (NHL). The most common AEs was peripheral neuropathy (38.0%). Meanwhile, AEs on skin (13.1-20.0%) and digestive system (9.0-36.0%) was hard be overlooked. ADC + ICI therapy may be recommended in cancer treatment, especially in cHL and NHL. However, strategies to manage toxicities warranted further exploration.

摘要

虽然抗体药物偶联物 (ADC) 或免疫检查点抑制剂 (ICI) 单独为癌症治疗带来了希望,但单一药物治疗的效果有限,ADC 和 ICI 治疗的安全性仍不清楚。本荟萃分析旨在研究 ADC 和 ICI 联合治疗的疗效和安全性。本研究类型为系统评价和荟萃分析。通过 PubMed、Embase、Cochrane 从成立到 2024 年 6 月 5 日进行文献检索。然后,在提取数据后,使用总缓解率 (ORR) 和不良反应 (AE) 来研究其效率和安全性。还通过漏斗图、贝格检验和埃格检验计算发表偏倚。通过亚组和敏感性分析研究异质性。研究方案在 PROSPERO(CRD42023375601)中注册。共纳入 12 项符合条件的临床研究,共 584 例患者。汇总的 ORR 为 58%(95%CI 46%,70%)。亚组分析显示经典霍奇金淋巴瘤(cHL)的 ORR 为 77%(95%CI 63%,91%),非霍奇金淋巴瘤(NHL)的 ORR 为 73%(95%CI 56%,90%)。最常见的 AE 是周围神经病(38.0%)。同时,皮肤(13.1-20.0%)和消化系统(9.0-36.0%)的 AE 不容忽视。ADC+ICI 治疗可能在癌症治疗中得到推荐,尤其是在 cHL 和 NHL 中。然而,管理毒性的策略需要进一步探索。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2080/11436769/cd02262dd999/41598_2024_68311_Fig1_HTML.jpg

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