Ahmadi Narjisse, Kadi Chaimae, Benlamari Maryam, Gaouzi Zainab, El Ouali El Mokhtar, Bouziane Amal, Abouqal Redouane, Ibrahimi Azeddine
Medical Biotechnology Laboratory (MedBiotech), Bioinova Research Center, Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Rabat, Morocco.
Mohammed VI Center for Research & Innovation, Rabat, Morocco.
Future Oncol. 2025 Jul 12:1-11. doi: 10.1080/14796694.2025.2530378.
Randomized controlled trials (RCTs) have assessed the efficacy of anti-programmed cell death 1 (PD- 1)/programmed cell death ligand 1 (PD-L1), alone or combined with other therapies, for ovarian cancer. However, the optimal strategy remains unclear. This study evaluated their effectiveness as monotherapy and in combination.
We conducted a systematic review and Frequentist network meta-analysis (NMA) by searching PubMed, ScienceDirect, Web of Science, Scopus, Cochrane Library, and Clinicaltrials.gov databases. This analysis included RCTs comparing PD-L1/PD-1 inhibitors, alone or in combination with other therapies.
Six studies involving 3,895 patients and eight treatment combinations were included. PD1/PDL1 inhibitors plus chemotherapy and PD1/PDL1 inhibitors plus ipilimumab showed the greatest progression-free survival (PFS) benefit (hazard ratio (HR) = 0.82, 95% confidence interval [CI]: 0.52-1.07; HR = 0.82, 95% CI:0.51-1.33) and overall survival (OS) (HR = 0.85, 95% CI:0.64-1.14; HR = 0.83, 95% CI:0.45-1.54). These combinations also improved overall response rates (ORR), especially with chemotherapy (OR = 3.06; 95% CI:1.42-6.60). Subgroup analysis suggested that PD-1/PD-L1 inhibitors plus chemotherapy provided the best PFS and OS in PD-L1-positive patients.
Combining PD-1/PD-L1 inhibitors with chemotherapy or ipilimumab improved survival in ovarian cancer. However, PD-L1 expression may be a valuable biomarker for predicting the efficacy of PD-1/PD-L1 checkpoint inhibitors.
This systematic review was preregistered in PROSPERO (CRD42022342057). Available from: https://www.crd.york.ac.uk/PROSPERO/view/CRD42022347967.
随机对照试验（RCT）已评估了抗程序性细胞死亡蛋白1（PD-1）/程序性细胞死亡配体1（PD-L1）单药或与其他疗法联合用于卵巢癌的疗效。然而，最佳策略仍不明确。本研究评估了它们作为单药治疗及联合治疗的有效性。
我们通过检索PubMed、ScienceDirect、Web of Science、Scopus、Cochrane图书馆和Clinicaltrials.gov数据库进行了一项系统评价和频率学派网状荟萃分析（NMA）。该分析纳入了比较PD-L1/PD-1抑制剂单药或与其他疗法联合使用的随机对照试验。
纳入了六项涉及3895例患者和八种治疗组合的研究。PD1/PDL1抑制剂加化疗以及PD1/PDL1抑制剂加伊匹木单抗显示出最大的无进展生存期（PFS）获益（风险比（HR）=0.82，95%置信区间[CI]：0.52-1.07；HR=0.82，95%CI：0.51-1.33）和总生存期（OS）（HR=0.85，95%CI：0.64-1.14；HR=0.83，95%CI：0.45-1.54）。这些联合治疗也提高了总体缓解率（ORR），尤其是与化疗联合时（OR=3.06；95%CI：1.42-6.60）。亚组分析表明，PD-1/PD-L1抑制剂加化疗在PD-L1阳性患者中提供了最佳的PFS和OS。
将PD-1/PD-L1抑制剂与化疗或伊匹木单抗联合可改善卵巢癌患者的生存期。然而，PD-L1表达可能是预测PD-1/PD-L1检查点抑制剂疗效的一个有价值的生物标志物。
本系统评价已在PROSPERO（CRD42022342057）中预注册。可从以下网址获取：https://www.crd.york.ac.uk/PROSPERO/view/CRD42022347967。
