Standard of care treatment for stage IVB cervical cancer: A systematic review and meta-analysis

IF 4.5 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Gynecologic oncology Pub Date : 2024-10-30 DOI:10.1016/j.ygyno.2024.10.023

Kyra S. Hunsberger , Krishnansu S. Tewari , Bradley J. Monk , Dana M. Chase

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引用次数: 0

Abstract

Objective

Our aim was to perform a systematic review and meta-analysis evaluating the efficacy of standard treatment for stage IVB cervical cancer.

Method

Databases were searched for Phase III trials evaluating stage IVB CC patients according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Systematic review included Phase III trials evaluating first-line treatment of stage IVB cervical cancer (CC). A meta-analysis was pursued for Phase III trials establishing standard of care treatment that included independent analyses of stage IVB, persistent, and recurrent CC.

Results

For the systematic review, 8 studies met inclusion criteria, with a total of 3,161 CC patients analyzed. Of these studies, three met criteria and included suitable data for meta-analysis – GOG 240, KEYNOTE-826, and BEATcc. Of the 1,479 women included in the meta-analysis, 289 (19.5 %) had stage IVB and 1,190 (80.5 %) had persistent or recurrent CC. HR of OS was 0.64 (95 % confidence interval (CI): 0.55–0.75) and 0.85 (95 % CI: 0.64–1.14) for persistent/recurrent and stage IVB CC, respectively. In the test of group differences, p-value was insignificant at 0.098.

Conclusion

While trials have assessed outcomes in stage IVB, persistent, and recurrent CC, new treatments demonstrate poorer PFS and OS for stage IVB compared to persistent and recurrent CC. The exact benefit for current standard of care for stage IVB CC could be better defined. Given that stage IVB CC has a different clinical course and treatment history compared to persistent and recurrent disease, stage IVB CC should be analyzed independently in future clinical trials.

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IVB 期宫颈癌的标准治疗：系统回顾和荟萃分析。

目的我们的目的是对IVB期宫颈癌标准治疗的疗效进行系统综述和荟萃分析评估：根据《2020 年系统综述和荟萃分析首选报告项目》（Preferred Reporting Items for Systematic Reviews and Meta-Analyses，PRISMA）指南，检索数据库中评估 IVB 期宫颈癌患者的 III 期试验。系统综述包括评估IVB期宫颈癌（CC）一线治疗的III期试验。荟萃分析针对的是确定标准治疗方法的 III 期试验，其中包括对 IVB 期、持续性和复发性 CC 的独立分析：在系统综述中，有 8 项研究符合纳入标准，共分析了 3,161 名 CC 患者。在这些研究中，有三项研究符合标准并包含适合进行荟萃分析的数据--GOG 240、KEYNOTE-826 和 BEATcc。在纳入荟萃分析的1,479名女性患者中，289人（19.5%）为IVB期，1,190人（80.5%）为持续性或复发性CC。持续/复发和IVB期CC的OS HR分别为0.64（95%置信区间（CI）：0.55-0.75）和0.85（95%置信区间（CI）：0.64-1.14）。在组间差异检验中，P值为0.098，不显著：结论：尽管试验评估了IVB期、持续性和复发性CC的疗效，但新疗法显示，与持续性和复发性CC相比，IVB期的PFS和OS较差。目前的标准疗法对IVB期CC的确切疗效有待进一步明确。鉴于IVB期CC的临床病程和治疗史与持续性和复发性疾病不同，在未来的临床试验中应单独分析IVB期CC。

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

Gynecologic oncology 医学-妇产科学

CiteScore

8.60

自引率

6.40%

发文量

1062

审稿时长

37 days

期刊介绍： Gynecologic Oncology, an international journal, is devoted to the publication of clinical and investigative articles that concern tumors of the female reproductive tract. Investigations relating to the etiology, diagnosis, and treatment of female cancers, as well as research from any of the disciplines related to this field of interest, are published. Research Areas Include: • Cell and molecular biology • Chemotherapy • Cytology • Endocrinology • Epidemiology • Genetics • Gynecologic surgery • Immunology • Pathology • Radiotherapy