Efficacy and safety of immune checkpoint inhibitors combined with anti-VEGF therapy in the treatment of unresectable or advanced liver cancer: a systematic review.

IF 2.9 4区 医学 Q3 IMMUNOLOGY
Wenchao Yang, Xiaofang Li, Jiana He, Qingqing Xuan, Haiyan Si, Weifen Yao
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引用次数: 0

Abstract

Objective: This study aimed to evaluate the clinical effects and safety of immune checkpoint inhibitors (ICIs) combined with anti-VEGF therapy for the treatment of unresectable or advanced liver cancer.

Method: Related databases were searched from inception to December 2022 to identify randomized controlled studies and clinical trials that evaluated the combination of ICIs and anti-VEGF therapy for the treatment of unresectable liver cancer. The outcome index was extracted and analyzed by RevMan5.4.ResultsA total of 8 clinical trials were included. In terms of efficacy, the intervention group had longer OS and PFS for unresectable or advanced liver cancer than the control group. In terms of safety, (1) Adverse events of all grades showed that the combination treatment led to significantly higher risks of urinary system disorders, cardiovascular system disorder, blood system disorders and liver dysfunction than the control treatment. Compared with monotherapy, the combination treatment led to lower risks of gastrointestinal disorders. (2) Adverse events above grade 3 showed that, compared with the control treatment, the combination treatment led to significantly higher risks of urinary system disorders, blood systeam disorders, cardiovascular system disorders and liver dysfunction. Additionally, compared with monotherapy, the combination treatment led to significantly lower risks of gastrointestinal disorders.

Conclusions: ICIs combined with anti-VEGF therapy exerts significant clinical effects in patients with unresectable or advanced liver cancer, can prolong the survival of these patients and can improve their quality of life. However, clinical attention should be given to the occurrence of adverse reactions.

免疫检查点抑制剂联合抗vegf治疗不可切除或晚期肝癌的疗效和安全性:系统综述
目的:本研究旨在评价免疫检查点抑制剂(ici)联合抗vegf治疗不可切除或晚期肝癌的临床疗效和安全性。方法:检索从成立到2022年12月的相关数据库,以确定评估ICIs联合抗vegf治疗不可切除肝癌的随机对照研究和临床试验。采用RevMan5.4提取结局指标并进行分析。结果共纳入8项临床试验。在疗效方面,干预组对不可切除或晚期肝癌的OS和PFS比对照组更长。安全性方面,(1)各等级不良事件均显示联合治疗导致泌尿系统疾病、心血管系统疾病、血液系统疾病和肝功能障碍的风险明显高于对照治疗。与单药治疗相比,联合治疗导致胃肠道疾病的风险较低。(2) 3级以上不良事件显示,与对照治疗相比,联合治疗导致泌尿系统疾病、血液系统疾病、心血管系统疾病和肝功能障碍的风险显著增加。此外,与单药治疗相比,联合治疗可显著降低胃肠道疾病的风险。结论:ICIs联合抗vegf治疗对不能切除或晚期肝癌患者临床疗效显著,可延长患者生存期,提高患者生活质量。但临床应注意不良反应的发生。
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来源期刊
CiteScore
5.40
自引率
0.00%
发文量
133
审稿时长
4-8 weeks
期刊介绍: The journal Immunopharmacology and Immunotoxicology is devoted to pre-clinical and clinical drug discovery and development targeting the immune system. Research related to the immunoregulatory effects of various compounds, including small-molecule drugs and biologics, on immunocompetent cells and immune responses, as well as the immunotoxicity exerted by xenobiotics and drugs. Only research that describe the mechanisms of specific compounds (not extracts) is of interest to the journal. The journal will prioritise preclinical and clinical studies on immunotherapy of disorders such as chronic inflammation, allergy, autoimmunity, cancer etc. The effects of small-drugs, vaccines and biologics against central immunological targets as well as cell-based therapy, including dendritic cell therapy, T cell adoptive transfer and stem cell therapy, are topics of particular interest. Publications pointing towards potential new drug targets within the immune system or novel technology for immunopharmacological drug development are also welcome. With an immunoscience focus on drug development, immunotherapy and toxicology, the journal will cover areas such as infection, allergy, inflammation, tumor immunology, degenerative disorders, immunodeficiencies, neurology, atherosclerosis and more. Immunopharmacology and Immunotoxicology will accept original manuscripts, brief communications, commentaries, mini-reviews, reviews, clinical trials and clinical cases, on the condition that the results reported are based on original, clinical, or basic research that has not been published elsewhere in any journal in any language (except in abstract form relating to paper communicated to scientific meetings and symposiums).
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