Xiong Jin, Jian Hongmei, Yang Zhenzhou, Xia Lei
Department of Cancer Center, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 401336, China.
Sci Rep. 2025 Aug 20;15(1):30606. doi: 10.1038/s41598-025-16236-6.
Anticoagulants were suggested to influence cancer survival by possible immunomodulatory effect. However, it remained unclear if concomitant use of anticoagulants and various types of them could influence the efficacy of immune checkpoint inhibitors (ICIs) in cancer patients. Accordingly, the meta-analysis was performed to systematically evaluate the effect of concomitant anticoagulants in cancer patients receiving ICIs. Relevant studies were obtained by literature search in PubMed, Embase, and Web of Science databases. A conservative random-effect model was used to combine the results. A total of 2686 patients were enrolled, including all the patients analyzed for overall survival (OS) and 2457 patients for progression-free survival (PFS). The publication types of these 5 studies were retrospective studies. We found that concomitant use of anticoagulants significantly impaired the PFS (hazard ratio (HR): 1.29, 95% confidence interval (CI): 1.10-1.51, p = 0.002) and OS (HR:1.26, 95% CI:1.07-1.47, p = 0.004) of cancer patients receiving ICIs. Subgroup analyses showed that there was worse OS in heparin product subgroup (HR, 2.90; 95%CI: 1.71-4.92, p < 0.001). Our findings suggested that concomitant use of anticoagulants seemed to significantly impair the survival of cancer patients treated with ICIs.
抗凝剂被认为可能通过免疫调节作用影响癌症患者的生存。然而，抗凝剂及其不同类型的联合使用是否会影响癌症患者免疫检查点抑制剂（ICI）的疗效仍不清楚。因此，进行了这项荟萃分析，以系统评估联合使用抗凝剂对接受ICI治疗的癌症患者的影响。通过在PubMed、Embase和Web of Science数据库中进行文献检索获得相关研究。采用保守的随机效应模型合并结果。共纳入2686例患者，包括所有分析总生存期（OS）的患者和2457例无进展生存期（PFS）的患者。这5项研究的发表类型均为回顾性研究。我们发现，联合使用抗凝剂显著损害了接受ICI治疗的癌症患者的PFS（风险比（HR）：1.29，95%置信区间（CI）：1.10-1.51，p = 0.002）和OS（HR：1.26，95%CI：1.07-1.47，p = 0.004）。亚组分析显示，肝素产品亚组的OS更差（HR，2.90；95%CI：1.71-4.92，p < 0.001）。我们的研究结果表明，联合使用抗凝剂似乎会显著损害接受ICI治疗的癌症患者的生存。
