VEGFR酪氨酸激酶抑制剂治疗胶质瘤患者的安全性和有效性:一项系统评价、荟萃分析及对胶质母细胞瘤的专项分析

The safety and efficacy of VEGFR tyrosine kinase inhibitors for patients with gliomas: a systematic review, meta-analysis, and a specific analysis on glioblastoma.

作者信息

Habibi Mohammad Amin, Rashidi Farhang, Hajikarimloo Bardia, Karami Shaghayegh, Fathi Tavani Sahar, Zare Amirhossein, Mirjani Mohammad Sina, Allahdadi Ali, Didehvar Kimia, Mohammadzadeh Ibrahim, Kaviari Mohammad Amin

机构信息

Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.

School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Neurosurg Rev. 2025 Apr 26;48(1):390. doi: 10.1007/s10143-025-03536-8.

Abstract

Gliomas account for 24.5% of all primary brain tumors and 80% of all malignant tumors in adults. Vascular endothelial growth factor receptors (VEGFR) tyrosine kinase inhibitors (TKIs) play an important role in disrupting angiogenesis, tumor growth, and invasion. This study evaluates the outcomes of VEGFR TKIs in patients with glioma, with a specific analysis on glioblastoma (GBM). Electronic databases of PubMed/Medline, Embase, Scopus, and Web of Science were conducted until 23 July 2024. Studies that evaluated the survival of patients with glioma treated with VEGFR TKI were included. All statistical analyses were conducted using the R program. A total of 24 studies, including 1,146 glioma patients with a median age range of 5.8 to 62 years were recruited. Regarding progression-free survival (PFS), the six-month PFS rate was reported with a pooled value of 21% [95% CI: 15% to 28%]. The 12-month PFS rate was evaluated in three studies, ranging from 5 to 38% with a pooled rate of 15% [95% CI: 8% to 27%]. Considering the radiological response, the pooled overall response rate (ORR) was 21% [95% CI: 15%-28%]. Evaluation of the subgroups based on drug type at the six-month follow-up showed no significant difference in overall survival (OS) rates among patients (p = 0.06). Our results revealed that VEGFR TKIs in patients with glioma, were associated with limited efficacy. The long-term effectiveness of these treatments remains controversial and requires longer follow-up, which is challenging in cancer cases.

摘要

胶质瘤占所有原发性脑肿瘤的24.5%,占成人所有恶性肿瘤的80%。血管内皮生长因子受体(VEGFR)酪氨酸激酶抑制剂(TKIs)在破坏血管生成、肿瘤生长和侵袭方面发挥着重要作用。本研究评估了VEGFR TKIs在胶质瘤患者中的疗效,并对胶质母细胞瘤(GBM)进行了具体分析。检索了截至2024年7月23日的PubMed/Medline、Embase、Scopus和Web of Science电子数据库。纳入评估接受VEGFR TKI治疗的胶质瘤患者生存情况的研究。所有统计分析均使用R程序进行。共纳入24项研究,包括1146例胶质瘤患者,中位年龄范围为5.8至62岁。关于无进展生存期(PFS),报告的六个月PFS率合并值为21%[95%置信区间:15%至28%]。三项研究评估了12个月的PFS率,范围为5%至38%,合并率为15%[95%置信区间:8%至27%]。考虑到放射学反应,合并的总缓解率(ORR)为21%[95%置信区间:15%-28%]。在六个月随访时基于药物类型对亚组进行评估,结果显示患者的总生存期(OS)率无显著差异(p = 0.06)。我们的结果显示,VEGFR TKIs对胶质瘤患者的疗效有限。这些治疗的长期有效性仍存在争议,需要更长时间的随访,而这在癌症病例中具有挑战性。

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