Efficacy and Safety of PD-1/PD-L1 Inhibitors Combined With Anti-Angiogenic Tyrosine Kinase Inhibitors for Recurrent or Metastatic Nasopharyngeal Carcinoma: A Systematic Review and Single-Arm Meta-Analysis.

IF 3.5 2区医学 Q2 ONCOLOGY

Cancer Medicine Pub Date : 2026-10-01 DOI:10.1002/cam4.72340

Rongyi Hu, Tiebin Li, Ziman Luo, Huining Chen, Song Qu

{"title":"Efficacy and Safety of PD-1/PD-L1 Inhibitors Combined With Anti-Angiogenic Tyrosine Kinase Inhibitors for Recurrent or Metastatic Nasopharyngeal Carcinoma: A Systematic Review and Single-Arm Meta-Analysis.","authors":"Rongyi Hu, Tiebin Li, Ziman Luo, Huining Chen, Song Qu","doi":"10.1002/cam4.72340","DOIUrl":null,"url":null,"abstract":"Objective: To evaluate the efficacy and safety of PD-1/PD-L1 inhibitors plus small-molecule anti-angiogenic drugs (apatinib, anlotinib and famitinib) for recurrent/metastatic nasopharyngeal carcinoma (R/M NPC).Methods: Systematic searches of major databases up to January 7, 2026 identified prospective single-arm Phase II trials and retrospective cohort/real-world studies of PD-1/PD-L1 inhibitors combined with apatinib, anlotinib, or famitinib in R/M NPC. Pooled response and safety rates were estimated using random-effects models, with study quality assessed by appropriate tools.Results: Nine studies comprising 10 independent cohorts (357 patients) were included. The pooled objective response rate (ORR) was 48% (95% CI: 39%-57%), the disease control rate (DCR) 83% (95% CI: 77%-88%), and the 1-year overall survival rate 79% (95% CI: 68%-86%). The incidence of grade ≥ 3 treatment-related adverse events (TRAEs) was 47% (95% CI: 37%-58%). The most frequent serious TRAEs were hypertension (9%), hand-foot syndrome (10%), and nasopharyngeal necrosis (14%), with the latter requiring close monitoring due to its potential for severe bleeding complications. No treatment-related deaths were reported across all included studies. Subgroup analysis showed no significant difference in ORR between camrelizumab and toripalimab; apatinib yielded higher ORR than anlotinib; immunotherapy-naive patients had significantly higher ORR than those previously treated with immune checkpoint inhibitors (ICIs) (p = 0.0028).Conclusion: The combination shows promising antitumor activity and a generally acceptable safety profile in R/M NPC, particularly for immunotherapy-naive patients. These findings support further investigation in well-designed randomized controlled trials, but confirmation of its role relative to standard therapies requires larger comparative studies.","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"15 10","pages":"e72340"},"PeriodicalIF":3.5000,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13624707/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cancer Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/cam4.72340","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

Objective: To evaluate the efficacy and safety of PD-1/PD-L1 inhibitors plus small-molecule anti-angiogenic drugs (apatinib, anlotinib and famitinib) for recurrent/metastatic nasopharyngeal carcinoma (R/M NPC).

Methods: Systematic searches of major databases up to January 7, 2026 identified prospective single-arm Phase II trials and retrospective cohort/real-world studies of PD-1/PD-L1 inhibitors combined with apatinib, anlotinib, or famitinib in R/M NPC. Pooled response and safety rates were estimated using random-effects models, with study quality assessed by appropriate tools.

Results: Nine studies comprising 10 independent cohorts (357 patients) were included. The pooled objective response rate (ORR) was 48% (95% CI: 39%-57%), the disease control rate (DCR) 83% (95% CI: 77%-88%), and the 1-year overall survival rate 79% (95% CI: 68%-86%). The incidence of grade ≥ 3 treatment-related adverse events (TRAEs) was 47% (95% CI: 37%-58%). The most frequent serious TRAEs were hypertension (9%), hand-foot syndrome (10%), and nasopharyngeal necrosis (14%), with the latter requiring close monitoring due to its potential for severe bleeding complications. No treatment-related deaths were reported across all included studies. Subgroup analysis showed no significant difference in ORR between camrelizumab and toripalimab; apatinib yielded higher ORR than anlotinib; immunotherapy-naive patients had significantly higher ORR than those previously treated with immune checkpoint inhibitors (ICIs) (p = 0.0028).

Conclusion: The combination shows promising antitumor activity and a generally acceptable safety profile in R/M NPC, particularly for immunotherapy-naive patients. These findings support further investigation in well-designed randomized controlled trials, but confirmation of its role relative to standard therapies requires larger comparative studies.

查看原文本刊更多论文

PD-1/PD-L1抑制剂联合抗血管生成酪氨酸激酶抑制剂治疗复发或转移性鼻咽癌的疗效和安全性：一项系统评价和单组荟萃分析

目的：评价PD-1/PD-L1抑制剂联合小分子抗血管生成药物（阿帕替尼、安洛替尼和法米替尼）治疗复发/转移性鼻咽癌（R/M鼻咽癌）的疗效和安全性。方法：系统检索截至2026年1月7日的主要数据库，确定PD-1/PD-L1抑制剂联合阿帕替尼、安洛替尼或法米替尼治疗R/M鼻咽癌的前瞻性单组II期试验和回顾性队列/现实研究。使用随机效应模型估计综合反应率和安全性，并使用适当的工具评估研究质量。结果：纳入了9项研究，包括10个独立队列（357例患者）。合并客观缓解率（ORR）为48% (95% CI: 39%-57%)，疾病控制率（DCR）为83% (95% CI: 77%-88%)， 1年总生存率为79% （95% CI: 68%-86%）。≥3级治疗相关不良事件（TRAEs）的发生率为47% （95% CI: 37%-58%）。最常见的严重TRAEs是高血压（9%）、手足综合征（10%）和鼻咽坏死（14%），后者因可能出现严重出血并发症而需要密切监测。所有纳入的研究均未报告与治疗相关的死亡。亚组分析显示，camrelizumab和toripalimab的ORR无显著差异；阿帕替尼的ORR高于安洛替尼；未接受免疫治疗的患者的ORR显著高于先前接受免疫检查点抑制剂（ICIs）治疗的患者（p = 0.0028）。结论：该组合在R/M鼻咽癌中显示出良好的抗肿瘤活性和普遍可接受的安全性，特别是对于未接受免疫治疗的患者。这些发现支持在精心设计的随机对照试验中进行进一步的研究，但要确认其相对于标准疗法的作用，还需要更大规模的比较研究。

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

Cancer Medicine ONCOLOGY-

CiteScore

5.50

自引率

2.50%

发文量

907

审稿时长

19 weeks

期刊介绍： Cancer Medicine is a peer-reviewed, open access, interdisciplinary journal providing rapid publication of research from global biomedical researchers across the cancer sciences. The journal will consider submissions from all oncologic specialties, including, but not limited to, the following areas: Clinical Cancer Research Translational research ∙ clinical trials ∙ chemotherapy ∙ radiation therapy ∙ surgical therapy ∙ clinical observations ∙ clinical guidelines ∙ genetic consultation ∙ ethical considerations Cancer Biology: Molecular biology ∙ cellular biology ∙ molecular genetics ∙ genomics ∙ immunology ∙ epigenetics ∙ metabolic studies ∙ proteomics ∙ cytopathology ∙ carcinogenesis ∙ drug discovery and delivery. Cancer Prevention: Behavioral science ∙ psychosocial studies ∙ screening ∙ nutrition ∙ epidemiology and prevention ∙ community outreach. Bioinformatics: Gene expressions profiles ∙ gene regulation networks ∙ genome bioinformatics ∙ pathwayanalysis ∙ prognostic biomarkers. Cancer Medicine publishes original research articles, systematic reviews, meta-analyses, and research methods papers, along with invited editorials and commentaries. Original research papers must report well-conducted research with conclusions supported by the data presented in the paper.