Wang Simin, Wu Jiyong, Zhang Wenfei, Nie Jing
Department of Pharmacy, Shandong Second Provincial General Hospital, Jinan, China.
School of Food and Biological Engineering, Yantai Institute of Technology, Yantai, China.
Future Oncol. 2025 Jul;21(17):2237-2249. doi: 10.1080/14796694.2025.2516408. Epub 2025 Jun 18.
Temozolomide combined with radiotherapy has been widely recognized as the first-line treatment for glioblastoma. However, a standard treatment regimen for recurrent glioblastoma after treatment with temozolomide plus radiotherapy is lacking at present. This network meta-analysis aimed to assess and rank the therapeutic efficacy and safety of temozolomide plus radiotherapy combined with 11 other anti-cancer treatments in glioblastoma so as to provide valuable evidence for appropriate clinical decision-making.
Eligible studies investigating the efficacy and safety of temozolomide plus radiotherapy (standard treatment) compared to combination therapies were obtained by searching PubMed, Cochrane Library, and EMBASE. Outcomes included progression-free survival, overall survival, and grade 3-5 adverse events.
A total of 16 studies were included in this meta-analysis. Except for autologous lymphoid effector cells specific against tumor, galunisertib, and interferon-β, other anti-cancer treatments used in combination with standard treatment resulted in a survival advantage over standard treatment alone. The combination of nimustine with standard treatment performed best in improving overall survival and progression-free survival and exhibited a favorable safety profile, making it the optimal treatment option for recurrent glioblastoma.
After a comprehensive safety analysis, nimustine and lomustine were identified as effective drugs that could be combined with standard treatment.
www.crd.york.ac.uk/prospero identifier is CRD420251004329.
替莫唑胺联合放疗已被广泛认可为胶质母细胞瘤的一线治疗方法。然而，目前缺乏替莫唑胺加放疗治疗后复发性胶质母细胞瘤的标准治疗方案。这项网络荟萃分析旨在评估替莫唑胺加放疗联合其他11种抗癌治疗方法在胶质母细胞瘤中的治疗效果和安全性，并进行排名，以便为适当的临床决策提供有价值的证据。
通过检索PubMed、Cochrane图书馆和EMBASE获得符合条件的研究，这些研究调查了替莫唑胺加放疗（标准治疗）与联合治疗相比的疗效和安全性。结局指标包括无进展生存期、总生存期和3-5级不良事件。
本荟萃分析共纳入16项研究。除了肿瘤特异性自体淋巴效应细胞、加鲁尼西单抗和干扰素-β外，其他与标准治疗联合使用的抗癌治疗方法均比单独使用标准治疗具有生存优势。尼莫司汀与标准治疗联合使用在改善总生存期和无进展生存期方面表现最佳，且安全性良好，使其成为复发性胶质母细胞瘤的最佳治疗选择。
经过全面的安全性分析，尼莫司汀和洛莫司汀被确定为可与标准治疗联合使用的有效药物。
