Safety and efficacy of PD-1/PD-L1 immune checkpoint inhibitors in patients with pre-treated advanced stage malignant mesothelioma: a systematic review and meta-analysis.

IF 3.4 2区 医学 Q2 ONCOLOGY
Amjad Zafar, Asma Abdul Rashid, Abdul Moeed, Muhammad Junaid Tahir, Ahmad Jamal Khan, Oadi N Shrateh, Ali Ahmed
{"title":"Safety and efficacy of PD-1/PD-L1 immune checkpoint inhibitors in patients with pre-treated advanced stage malignant mesothelioma: a systematic review and meta-analysis.","authors":"Amjad Zafar, Asma Abdul Rashid, Abdul Moeed, Muhammad Junaid Tahir, Ahmad Jamal Khan, Oadi N Shrateh, Ali Ahmed","doi":"10.1186/s12885-024-13127-3","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Malignant mesothelioma is an aggressive cancer with poor prognosis. Programmed cell death protein-1 (PD-1) and its ligand 1 (PD-L1) immune checkpoint inhibitors (ICIs) have recently presented as a viable option in some first line but primarily as a second-line treatment of advanced-stage malignant mesothelioma (asMM). Therefore, this systematic review and meta-analysis aims to assess the safety and efficacy of PD-1/L-1 ICIs in advanced-stage malignant mesothelioma.</p><p><strong>Methods: </strong>PubMed, Scopus, and Cochrane databases were searched for all studies assessing the safety and efficacy of anti PD-1/PD-L1 agents. Primary outcomes were objective response rate (ORR) and disease control rate (DCR). Secondary outcomes were median progression free (mPFS) and overall survival (mOS). Safety outcomes were treatment- (TRAEs) and immune-related adverse events (IRAEs). A random-effects meta-analysis was performed to pool medians and to derive event rates.</p><p><strong>Results: </strong>A total of 15 studies were included with total of 1064 asMM patients. ORR and DCR were 16% and 57%, respectively. A pooled mPFS was 4.53 (CI: 3.40-5.65) and mOS was 10.51 (CI: 9.03-12.00). Overall TRAEs had an event rate of 0.69 (0.50-0.83) whereas IRAEs had an event rate of 0.28 (0.15-0.46). There were no significant differences between pembrolizumab, nivolumab primarily, and avelumab subgroups for all the outcomes. Additionally, meta-regression found no covariate to be a significant factor in ORR and DCR.</p><p><strong>Conclusion: </strong>In this meta-analysis we found that anti-PD1/PD-L1 treatment could be useful in pretreated asMM as they had at least comparable or greater mPFS, mOS, ORR, and DCR than other second-line agents currently being used.</p><p><strong>Registration number: </strong>This systematic review was registered at PROSPERO prior to the literature search, CRD42023442350.</p>","PeriodicalId":9131,"journal":{"name":"BMC Cancer","volume":"24 1","pages":"1353"},"PeriodicalIF":3.4000,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11536716/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMC Cancer","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12885-024-13127-3","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Background: Malignant mesothelioma is an aggressive cancer with poor prognosis. Programmed cell death protein-1 (PD-1) and its ligand 1 (PD-L1) immune checkpoint inhibitors (ICIs) have recently presented as a viable option in some first line but primarily as a second-line treatment of advanced-stage malignant mesothelioma (asMM). Therefore, this systematic review and meta-analysis aims to assess the safety and efficacy of PD-1/L-1 ICIs in advanced-stage malignant mesothelioma.

Methods: PubMed, Scopus, and Cochrane databases were searched for all studies assessing the safety and efficacy of anti PD-1/PD-L1 agents. Primary outcomes were objective response rate (ORR) and disease control rate (DCR). Secondary outcomes were median progression free (mPFS) and overall survival (mOS). Safety outcomes were treatment- (TRAEs) and immune-related adverse events (IRAEs). A random-effects meta-analysis was performed to pool medians and to derive event rates.

Results: A total of 15 studies were included with total of 1064 asMM patients. ORR and DCR were 16% and 57%, respectively. A pooled mPFS was 4.53 (CI: 3.40-5.65) and mOS was 10.51 (CI: 9.03-12.00). Overall TRAEs had an event rate of 0.69 (0.50-0.83) whereas IRAEs had an event rate of 0.28 (0.15-0.46). There were no significant differences between pembrolizumab, nivolumab primarily, and avelumab subgroups for all the outcomes. Additionally, meta-regression found no covariate to be a significant factor in ORR and DCR.

Conclusion: In this meta-analysis we found that anti-PD1/PD-L1 treatment could be useful in pretreated asMM as they had at least comparable or greater mPFS, mOS, ORR, and DCR than other second-line agents currently being used.

Registration number: This systematic review was registered at PROSPERO prior to the literature search, CRD42023442350.

PD-1/PD-L1免疫检查点抑制剂对预治疗晚期恶性间皮瘤患者的安全性和有效性:系统综述和荟萃分析。
背景:恶性间皮瘤是一种侵袭性癌症,预后较差。程序性细胞死亡蛋白-1(PD-1)及其配体1(PD-L1)免疫检查点抑制剂(ICIs)最近已成为晚期恶性间皮瘤(asMM)一线治疗的可行选择,但主要是二线治疗。因此,本系统综述和荟萃分析旨在评估PD-1/L-1 ICIs在晚期恶性间皮瘤中的安全性和有效性:方法:在PubMed、Scopus和Cochrane数据库中检索所有评估抗PD-1/PD-L1药物安全性和有效性的研究。主要结果为客观反应率(ORR)和疾病控制率(DCR)。次要结果为中位无进展生存期(mPFS)和总生存期(mOS)。安全性结果为治疗不良事件(TRAEs)和免疫相关不良事件(IRAEs)。研究人员进行了随机效应荟萃分析,以得出中位数和事件发生率:共有15项研究纳入了1064例asMM患者。ORR和DCR分别为16%和57%。汇总的 mPFS 为 4.53(CI:3.40-5.65),mOS 为 10.51(CI:9.03-12.00)。总体而言,TRAEs的事件发生率为0.69(0.50-0.83),而IRAEs的事件发生率为0.28(0.15-0.46)。在所有结果中,pembrolizumab、主要是 nivolumab 和 avelumab 亚组之间没有明显差异。此外,荟萃回归发现没有协变量是影响 ORR 和 DCR 的重要因素:在这项荟萃分析中,我们发现抗PD1/PD-L1治疗可用于预处理的asMM,因为与目前使用的其他二线药物相比,抗PD1/PD-L1治疗至少具有相当或更高的mPFS、mOS、ORR和DCR:本系统综述在文献检索前已在 PROSPERO 注册,注册号为 CRD42023442350。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
BMC Cancer
BMC Cancer 医学-肿瘤学
CiteScore
6.00
自引率
2.60%
发文量
1204
审稿时长
6.8 months
期刊介绍: BMC Cancer is an open access, peer-reviewed journal that considers articles on all aspects of cancer research, including the pathophysiology, prevention, diagnosis and treatment of cancers. The journal welcomes submissions concerning molecular and cellular biology, genetics, epidemiology, and clinical trials.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信