Maimaitiyiming Nuerbiyamu, Li Yue, Cao Yunfeng, Li Yanwei
Department of Integrative Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy of Tianjin, Tianjin, China.
Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin 300192, China.
Ther Adv Med Oncol. 2024 Oct 4;16:17588359241284904. doi: 10.1177/17588359241284904. eCollection 2024.
Many studies show that camrelizumab combination therapy can significantly improve progression-free survival (PFS) and overall survival (OS) in non-small cell lung cancer (NSCLC). However, the time of camrelizumab to market is short, and there is no systematic evaluation of camrelizumab-based comprehensive treatment of NSCLC.
To systematically evaluate the efficacy and safety of camrelizumab in comprehensively treating NSCLC.
A systematic review and meta-analysis.
Databases, including PubMed, Web of Science, Embase, and Cochrane, were searched by computer before August 2023 based on Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines, and reports on the efficacy and safety of camrelizumab-based treatment for NSCLC were collected, and RevMan 5.4 software was employed for meta-analysis finally.
Totally, 5 RCTs, 2 cohort studies, and 12 single-arm studies were included. The meta-analysis results revealed that, compared with the treatment without camrelizumab, the camrelizumab-based combination treatment considerably extended the OS (hazard ratio (HR) = 0.60, 95% confidence interval (CI): (0.44-0.82), < 0.01), PFS (HR = 0.42, 95% CI: (0.28-0.63), < 0.01), and event-free survival (EFS) (HR = 0.55, 95% CI: (0.44-0.68), < 0.01). The median objective response rate in single-arm studies was 41% (95% CI: 28%-53%), and the disease control rate was 84% (95% CI: 78%-89%). Furthermore, in terms of the occurrence of grades 3-5 adverse events, the incidence of neutropenia was lower in the camrelizumab combination group than in the control group, while the incidence of leukopenia and rash was higher than in the combination group, and no significant difference was revealed in the incidence of other adverse events. Among single-arm studies, the incidence of grades 3-5 adverse events did not exceed 10%.
Treatment combined with camrelizumab can effectively prolong OS, PFS, and EFS in NSCLC patients with good safety, camrelizumab combined with chemotherapy is an effective treatment option for NSCLC patients.
多项研究表明，卡瑞利珠单抗联合治疗可显著提高非小细胞肺癌（NSCLC）患者的无进展生存期（PFS）和总生存期（OS）。然而，卡瑞利珠单抗上市时间较短，目前尚无对以卡瑞利珠单抗为基础的NSCLC综合治疗的系统评价。
系统评价卡瑞利珠单抗综合治疗NSCLC的疗效和安全性。
系统评价与Meta分析。
根据系统评价和Meta分析的首选报告项目（PRISMA）指南，于2023年8月前通过计算机检索PubMed、Web of Science、Embase和Cochrane等数据库，收集以卡瑞利珠单抗为基础治疗NSCLC的疗效和安全性报告，最终采用RevMan 5.4软件进行Meta分析。
共纳入5项随机对照试验（RCT）、2项队列研究和12项单臂研究。Meta分析结果显示，与未使用卡瑞利珠单抗的治疗相比，以卡瑞利珠单抗为基础的联合治疗显著延长了总生存期（风险比（HR）=0.60，95%置信区间（CI）：（0.44-0.82），P<0.01）、无进展生存期（HR=0.42，95%CI：（0.28-0.63），P<0.01）和无事件生存期（EFS）（HR=0.55，95%CI：（0.44-0.68），P<0.01）。单臂研究中的中位客观缓解率为41%（95%CI：28%-53%），疾病控制率为84%（95%CI：78%-89%）。此外，在3-5级不良事件的发生方面，卡瑞利珠单抗联合治疗组中性粒细胞减少症的发生率低于对照组，而白细胞减少症和皮疹的发生率高于联合治疗组，其他不良事件的发生率无显著差异。在单臂研究中，3-5级不良事件的发生率不超过10%。
卡瑞利珠单抗联合治疗可有效延长NSCLC患者的总生存期、无进展生存期和无事件生存期，安全性良好，卡瑞利珠单抗联合化疗是NSCLC患者的一种有效治疗选择。
