Zhang Jiawen, Xu Lei, Sun Caifeng, Huang Zonghua, Ma Ji, Wang Liang
Clinical Medicine School, Shandong Second Medical University, No. 4948, Victory East Street, Weifang, Shandong, 261000, China.
Qilu Hospital of Shandong University, Dezhou Hospital, No. 1 Shangde Sixth Road, Decheng District, Dezhou, Shandong, 253000, China.
Open Life Sci. 2025 Aug 5;20(1):20251129. doi: 10.1515/biol-2025-1129. eCollection 2025.
This article conducts a meta-analysis to evaluate the safety and efficacy of PD-1/PD-L1 inhibitors in patients with relapsed/refractory diffuse large B-cell lymphoma (R/R DLBCL). A total of 63 papers were initially retrieved, and eight clinical studies were collected. The estimated effect of ORR was [OR = 0.40, 95% CI 0.29-0.51; = 0.08], the estimated effect of complete response rate was [OR = 0.21, 95% CI 0.14-0.31; < 0.001], while the estimated effect of 1-year progression-free survival was [OR = 0.33, 95% CI 0.22-0.47; = 0.01]. The estimated effect of 1-year OS was [OR = 0.67, 95% CI 0.55-0.77; = 0.05]. In addition, the estimated effect of grade 3 adverse events was [OR = 0.33, 95% CI 0.22-0.46; = 0.01]. Overall, PD-1/PD-L1 inhibitors demonstrated suboptimal therapeutic efficacy in the selected trials for R/R DLBCL. However, combining PD-1/PD-L1 inhibitors with CAR-T showed potential for improved treatment outcomes. Additionally, PD-1/PD-L1 inhibitors were found to be safe and well-tolerated in patients with R/R DLBCL.
本文进行了一项荟萃分析，以评估PD-1/PD-L1抑制剂在复发/难治性弥漫性大B细胞淋巴瘤（R/R DLBCL）患者中的安全性和疗效。最初检索到63篇论文，收集了8项临床研究。客观缓解率（ORR）的估计效应为[比值比（OR）=0.40，95%置信区间（CI）0.29 - 0.51；P=0.08]，完全缓解率的估计效应为[OR = 0.21，95%CI 0.14 - 0.31；P<0.001]，而1年无进展生存率的估计效应为[OR = 0.33，95%CI 0.22 - 0.47；P=0.01]。1年总生存率（OS）的估计效应为[OR = 0.67，95%CI 0.55 - 0.77；P=0.05]。此外，3级不良事件的估计效应为[OR = 0.33，95%CI 0.22 - 0.46；P=0.01]。总体而言，在针对R/R DLBCL的选定试验中，PD-1/PD-L1抑制剂显示出次优的治疗效果。然而，将PD-1/PD-L1抑制剂与嵌合抗原受体T细胞（CAR-T）联合使用显示出改善治疗结果的潜力。此外，发现PD-1/PD-L1抑制剂在R/R DLBCL患者中是安全且耐受性良好的。
Cochrane Database Syst Rev. 2021-9-13
Cochrane Database Syst Rev. 2018-2-6
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