Immune checkpoint inhibitor combined with chemotherapy versus chemotherapy alone in the first-line treatment for recurrent or metastatic nasopharyngeal carcinoma: a meta-analysis of random controlled trials.

IF 1.9 3区医学 Q2 OTORHINOLARYNGOLOGY

European Archives of Oto-Rhino-Laryngology Pub Date : 2024-10-01 Epub Date: 2024-06-24 DOI:10.1007/s00405-024-08768-w

Shuangyue Wang, Xiaojie Huang, Rong Li, Ziyan Zhou, Min Kang

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引用次数: 0

Abstract

Purpose: Immune checkpoint inhibitor (ICI) monotherapy and chemotherapy (CT) have been used to treat recurrent or metastatic nasopharyngeal carcinoma (R/M-NPC), with demonstrated survival benefits and good safety. However, whether combination therapy is superior to CT alone remains unclear. We summarized the existing evidence comparing the effectiveness and toxicities of ICI combined with CT versus CT alone.

Methods: Online databases was conducted for eligible randomized controlled trials (RCTs) published up to November 1, 2023. Progression-free survival (PFS) and overall survival (OS) were the primary endpoint. Objective response rates (ORRs) and adverse events (AEs) were the secondary endpoint.

Results: Three randomized controlled trials (Capture-1st, JUPITER-02, and RATIONALE-309) were included. First-line ICI therapy combined with CT showed significant improvement in PFS (hazard ratio[HR], 0.53; 95% confidence interval[CI]: 0.44-0.64), OS (HR, 0.63;95%CI: 0.49-0.81) and ORRs (odds ratio[OR], 1.79;95%CI: 1.30-2.46), when compared with CT alone. AEs ≥ grade 3 during treatment and treatment-related deaths were not significantly different between the two groups.

Conclusions: In patients with R/M-NPC, ICI therapy combined with CT showed improved ORRs, PFS, and OS, with similar safety as CT alone.

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免疫检查点抑制剂联合化疗与单用化疗一线治疗复发性或转移性鼻咽癌：随机对照试验荟萃分析。

目的：免疫检查点抑制剂（ICI）单药疗法和化疗（CT）已被用于治疗复发性或转移性鼻咽癌（R/M-NPC），并取得了明显的生存获益和良好的安全性。然而，联合疗法是否优于单用 CT 仍不清楚。我们总结了现有的证据，比较了 ICI 联合 CT 与单用 CT 的有效性和毒性：在线数据库检索了截至2023年11月1日发表的符合条件的随机对照试验（RCT）。无进展生存期（PFS）和总生存期（OS）是主要终点。客观反应率（ORR）和不良事件（AE）是次要终点：结果：纳入了三项随机对照试验（Capture-1st、JUPITER-02 和 RATIONALE-309）。与单用CT相比，一线ICI治疗联合CT可显著改善PFS（危险比[HR]，0.53；95%置信区间[CI]：0.44-0.64）、OS（HR，0.63；95%CI：0.49-0.81）和ORR（几率比[OR]，1.79；95%CI：1.30-2.46）。两组患者在治疗期间发生的≥3级的AE和治疗相关死亡没有显著差异：在R/M-NPC患者中，ICI治疗联合CT可改善ORR、PFS和OS，安全性与单用CT相似。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Archives of Oto-Rhino-Laryngology 医学-耳鼻喉科学

CiteScore

5.30

自引率

7.70%

发文量

537

审稿时长

2-4 weeks

期刊介绍： Official Journal of European Union of Medical Specialists – ORL Section and Board Official Journal of Confederation of European Oto-Rhino-Laryngology Head and Neck Surgery "European Archives of Oto-Rhino-Laryngology" publishes original clinical reports and clinically relevant experimental studies, as well as short communications presenting new results of special interest. With peer review by a respected international editorial board and prompt English-language publication, the journal provides rapid dissemination of information by authors from around the world. This particular feature makes it the journal of choice for readers who want to be informed about the continuing state of the art concerning basic sciences and the diagnosis and management of diseases of the head and neck on an international level. European Archives of Oto-Rhino-Laryngology was founded in 1864 as "Archiv für Ohrenheilkunde" by A. von Tröltsch, A. Politzer and H. Schwartze.