Gynecologic and Obstetric Investigation最新文献

{"title":"The Potency of Adipose-Derived Mesenchymal Stem Cells to Increase Ovarian Function in Primary Ovarian Insufficiency: A Systematic Review of in vivo Studies.","authors":"Yohanes Iddo Adventa, Yohanes Iddo Adventa, Anita Rachmawati, Dian Tjahyadi","doi":"10.1159/000544721","DOIUrl":"10.1159/000544721","url":null,"abstract":"<p><strong>Introduction: </strong>Primary ovarian insufficiency (POI) that caused infertility could decrease the quality of life in women. Therefore, an effective treatment is needed. Adipose-derived stem cells (ADSCs) have been reported to have therapeutic benefits in POI. This review aims to evaluate the therapeutic effect of ADSCs in POI.</p><p><strong>Methods: </strong>Literature studies were searched according to PRISMA 2020 guidelines in the following databases: PubMed, ProQuest, Wiley, Emerald, and JSTOR (until July 10th, 2024). The study inclusion criteria are original articles, in vivo study with adipose-derived stem cell therapy towards POI with ovarian function as the outcome. SYRCLE's risk of bias tool was used to evaluate the quality of the studies.</p><p><strong>Results: </strong>We retrieved 9 from 292 articles published in English between 2013 and 2024. Animals used in this study were mice (n = 5) and rats (n = 4). ADSCs were administered either systematically or directly by injection into the ovaries. Decreased apoptosis, increased follicle survival, and hormone levels were observed. These showed that ADSCs implantation could improve ovarian function in rats and mice. Overall, ADSCs in POI showed satisfactory results.</p><p><strong>Conclusion: </strong>ADSCs showed benefits in increasing ovarian function in POI. Further studies, especially human studies, are needed to evaluate the efficacy and side effects of the ADSCs treatment before reaching general conclusions.</p>","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"504-514"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oocyte Quality in Women with Endometriosis.","authors":"Rafael Trinchant, Juan Antonio García-Velasco","doi":"10.1159/000541615","DOIUrl":"10.1159/000541615","url":null,"abstract":"<p><strong>Background: </strong>Endometriosis is a chronic gynecological condition that affects approximately 10% of women of reproductive age globally. It is associated with significant morbidity due to symptoms such as pelvic pain and infertility. Current knowledge suggests that endometriosis impacts oocyte quality, a critical factor for successful fertilization and pregnancy. Despite extensive research, the exact mechanisms remain unclear, and further updates are necessary to optimize treatment strategies.</p><p><strong>Objectives: </strong>This review aims to summarize current evidence regarding the impact of endometriosis on oocyte quality and its subsequent effects on fertility outcomes, particularly in the context of in vitro fertilization (IVF).</p><p><strong>Methods: </strong>A comprehensive search was conducted in PubMed using the terms \"endometriosis AND oocyte quality,\" \"endometriosis AND infertility, and \"endometriosis AND IVF.\" The review included studies published up to July 2024.</p><p><strong>Outcome: </strong>The review findings indicate that endometriosis may be associated with decreased oocyte quality, characterized by impaired morphological features and molecular abnormalities. These defects potentially lead to lower fertilization rates, impaired embryo development, and reduced pregnancy outcomes. However, some studies suggest that with controlled factors such as age and ovarian reserve, IVF outcomes may be comparable to those without endometriosis.</p><p><strong>Conclusions and outlook: </strong>For clinicians and scientists working in medically assisted reproduction, understanding the impact of endometriosis on oocyte quality is crucial for improving fertility treatment outcomes. Advances in assisted reproductive technologies and personalized treatment approaches may mitigate these adverse effects. The potential for using artificial intelligence to assess oocyte quality presents a promising avenue for future research, as currently there is no direct and objective measure to assess this parameter.</p>","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"173-181"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142345576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancements in Ultrasound Diagnosis of Superficial Endometriosis: Current Challenges and Emerging Techniques.","authors":"Shay M Freger, Mathew Leonardi","doi":"10.1159/000543075","DOIUrl":"10.1159/000543075","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Endometriosis is a chronic disease characterized by endometrial-like tissue outside the uterus. Superficial endometriosis (SE) is the most prevalent form, yet it remains underdiagnosed due to subtle clinical and imaging presentations. Traditionally, diagnosis relies on laparoscopy, which is relatively invasive and often contributes to diagnostic delay. With advancements in imaging techniques, especially transvaginal ultrasound (TVS), a reassessment of the diagnostic approach for SE is needed. This review updates the understanding of SE diagnostics and integrates both historical perspectives and contemporary clinical insights.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;The review aimed to explore advancements in the diagnosis of SE, focusing on the growing role of TVS as a non-invasive diagnostic tool. Additionally, it seeks to highlight emerging diagnostic challenges and present new approaches to managing SE to offer updated recommendations for clinicians.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A comprehensive literature search was conducted using PubMed, MEDLINE, and Google Scholar. The following keywords were used: \"superficial endometriosis,\" \"diagnostic pathways,\" \"endometriosis diagnosis,\" \"superficial lesions,\" \"transvaginal ultrasound,\" \"laparoscopy,\" \"non-invasive imaging,\" and \"diagnostic accuracy.\" Only English-language articles were included, focusing on original research, metanalyses, and clinical guidelines, offering historical and current perspectives. In addition to the literature review, contemporary insights were gathered from our clinical practice at a tertiary endometriosis clinic to offer real-world context to the literature findings.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcome: &lt;/strong&gt;The review highlights TVS as a promising non-invasive method for diagnosing SE. While SE has historically been diagnosed through laparoscopy, TVS is gaining recognition as a valuable tool for detecting SE lesions, particularly through the identification of key sonographic features such as hyperechoic foci and cystic spaces. These advancements help overcome the challenges posed by the variability of SE presentation on imaging. Emerging techniques, such as sonoPODography, further enhance SE diagnosis and offer the potential for broader clinical application. Despite challenges such as the need for operator expertise and variability in lesion presentation, the literature and clinical insights support the growing utility of TVS in diagnosing SE.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions and outlook: &lt;/strong&gt;TVS has significant potential as a non-invasive diagnostic tool for SE. While limitations such as variability in sensitivity and the need for operator expertise remain, TVS can significantly reduce reliance on invasive methods like laparoscopy. Additionally, the review provides insights into managing cases, where TVS results are negative for SE. In such cases, clinicians must adopt a patient-centered approach that emphasizes symptom management, patient autonomy, an","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"363-373"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retraction Statement.","authors":"","doi":"10.1159/000546086","DOIUrl":"10.1159/000546086","url":null,"abstract":"","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"381"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Progesterone Vaginal Gel or Combined Medication for Luteal-Phase Support of Frozen-Thawed Embryo Transfer Cycles: A Single-Centre, Chinese, Randomized, Open-Label, Pilot Study.","authors":"Rui Yang, Ningning Pan, Xiumei Zhen, Yanhong Fan, Jianhuai Zheng, Yuanyuan Wang, Qiao Liu, Xun Liao, Rui Yang","doi":"10.1159/000544065","DOIUrl":"10.1159/000544065","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to explore potential differences in efficacy between vaginal progesterone (VPG) and VPG + oral progesterone (OPG) for luteal-phase support in hormone replacement therapy-frozen embryo transfer (HRT-FET) cycles.</p><p><strong>Design: </strong>A single-centre, open-label, randomized controlled, phase IV pilot study was conducted.</p><p><strong>Participants/materials, setting, methods: </strong>Infertile women aged 20-38 years undergoing HRT-FET cycles were included. Participants were randomized to VPG (n = 86) or VPG + OPG (n = 86). The primary efficacy endpoint was ongoing pregnancy at 10-12 weeks. Secondary efficacy endpoints included β-human chorionic gonadotropin (β-hCG) positivity, implantation rate, and clinical-pregnancy rate. Safety analyses included adverse events (AE) and vital signs.</p><p><strong>Results: </strong>A higher ongoing pregnancy rate was observed with VPG + OPG (29.1%) versus VPG (18.8%); treatment difference 8.4% (90% confidence interval [CI] -2.2%, 19.0%). Numerical differences also favoured VPG + OPG over VPG for β-hCG positivity (0.9% [90% CI: -10.8%, 12.7%]), implantation (10.4% [90% CI: 0.5%, 21.3%]), and clinical pregnancy (10.1% [90% CI: -0.8%, 21.1%]). Incidences of treatment-emergent AEs were comparable.</p><p><strong>Limitations: </strong>The single-centre study was limited by a relatively small sample size which could have impacted the reported outcomes. Another limitation was the open-label design, which might have increased the risk of bias for subjective endpoints, such as AE reporting.</p><p><strong>Conclusions: </strong>A higher ongoing pregnancy rate was observed with VPG + OPG vs VPG; however, a statistical conclusion cannot be reached considering the small sample size. These data suggest that a minimum daily progesterone dose, such as VPG 90 mg + OPG 20 mg reported here, or VPG 180 mg reported in other studies, may be required for successful outcomes following HRT-FET cycles.</p>","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"492-503"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Value of Human Epididymal Protein 4, Carcinoembryonic Antigen and Alpha-Fetoprotein in the Early Diagnosis of Cervical Cancer.","authors":"Xiaoyan Ye, Shanyan Xie","doi":"10.1159/000540855","DOIUrl":"10.1159/000540855","url":null,"abstract":"<p><strong>Objectives: </strong>This research aimed to unveil the value of human epididymal protein 4 (HE4), carcinoembryonic antigen (CEA) and alpha-fetoprotein (AFP) in the early diagnosis of cervical cancer.</p><p><strong>Design: </strong>This was a clinical study.</p><p><strong>Participants: </strong>Sixty patients with cervical cancer stage IA-IIA (early stage cervical cancer group), 60 patients with cervical intraepithelial neoplasia (CIN) (disease control group), and 60 healthy women who had passed the physical examination (healthy control group) were selected.</p><p><strong>Setting: </strong>The review was conducted in a Jiaxing First Hospital.</p><p><strong>Methods: </strong>Sixty patients with cervical cancer stage IA-IIA (early stage cervical cancer group), 60 patients with CIN (disease control group), and 60 healthy women who had passed the physical examination (healthy control group) were selected. The expression levels of serum HE4, CEA, and AFP in the three groups were detected, and the correlation between the levels of serum HE4, CEA, and AFP and the clinicopathological characteristics of patients with early stage cervical cancer were analyzed, and the receiver operating characteristic (ROC) curves were plotted to identify the value of the single and triple tests of serum HE4, CEA, and AFP for the early stage diagnosis of cervical cancer.</p><p><strong>Results: </strong>The levels of serum HE4, CEA, and AFP in the early stage cervical cancer group were higher than those in the disease control and the healthy control groups (p < 0.05). The levels of serum HE4, CEA, and AFP were related to the FIGO stage as well as the histological grading of patients with early stage cervical cancer (p < 0.05). The results of the ROC curves revealed that the AUC areas of HE4, CEA, and AFP for single as well as triple diagnosis of patients with early stage cervical cancer were 0.725, 0.679, 0.663, and 0.811, respectively, and the AUC of the three combined tests was markedly higher than that of HE4, CEA, AFP single test (p < 0.05).</p><p><strong>Limitations: </strong>There is a lack of larger sample sizes to test whether the combined HE4, CEA, and AFP detection has sufficient validity at the individual level and there are not enough serum samples in this study to perform circulating HPV-DNA detection and compare it with the levels of serum markers.</p><p><strong>Conclusion: </strong>The combination of HE4, CEA, and AFP has good clinical reference value analysis in the auxiliary diagnosis of early stage cervical cancer, and it is worthy of further validation and popularization.</p>","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"100-107"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142106887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Screening for and Treatment of Bacterial Vaginosis Reduced Preterm Delivery in High-Risk Pregnant Women: A Systematic Review and Meta-Analysis.","authors":"Enav Yefet, Dalit Mirin, Manal Massalha, Adi Alter, Zohar Nachum","doi":"10.1159/000543502","DOIUrl":"10.1159/000543502","url":null,"abstract":"<p><strong>Introduction: </strong>Bacterial vaginosis (BV) is a risk factor for preterm delivery. Yet, previous studies have found BV treatment ineffective in preventing preterm delivery in unselected population. This study aimed to evaluate the effectiveness of BV screening and treatment in reducing the rate of preterm deliveries before 37 weeks in high-risk women.</p><p><strong>Materials and methods: </strong>Embase, PubMed, Ovid-Medline, and Web of Science were searched. Randomized controlled trials that evaluated antibiotic treatment for BV versus no treatment/placebo were included. The primary outcome was the rate of preterm delivery and/or late miscarriages in pregnant women with a history of preterm delivery. The pooled relative risks (with 95% CI) were estimated. The Cochrane's Q test of heterogeneity, and I2 were used to assess heterogeneity. In total, 4,701 papers were retrieved of which seven met inclusion criteria and were analyzed.</p><p><strong>Results: </strong>Among the participating women, 738 were at high risk for preterm delivery and included in the analysis. Among them, 397 and 341 women received active or placebo treatment, respectively. The included studies had a low risk of bias. In six out of seven studies, the risk factor for preterm delivery was a previous preterm delivery. One study (N = 16) was excluded from the analysis since no group had preterm deliveries. Treatment for BV in high-risk women reduced the rate of preterm deliveries (pooled relative risk with 95% CI, 0.65 [0.44-0.98]). The protective effect of BV treatment was statistically significant in women treated with clindamycin, and when treatment was started after 20 gestational weeks.</p><p><strong>Conclusion: </strong>Screening for and treatment of BV may be effective in preventing preterm delivery in high-risk pregnant women. Randomized clinical trials are needed to confirm the findings of this study.</p>","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"353-362"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12324754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reproductive Outcomes in Infertile Women with Endometriosis Undergoing Assisted Reproductive Technology.","authors":"Can Benlioglu, Savci Bekir Telek, Baris Ata","doi":"10.1159/000543213","DOIUrl":"10.1159/000543213","url":null,"abstract":"<p><strong>Background: </strong>Endometriosis-related infertility and its treatment with assisted reproductive technologies (ART) have been broadly researched. Yet, underlying mechanisms of infertility, particularly in the absence of tubal dysfunction, remain unclear. While the impact of inflammatory milieu on the ovary and/or endometrium has been indicated as a contributing factor, recent evidence from euploid transfers and donor cycles questions the extent of these effects. Moreover, the frequent coexistence of other confounders, such as adenomyosis, further complicates the clinical picture, making it difficult to isolate the specific impact of endometriosis on ART outcomes.</p><p><strong>Objectives: </strong>The aim of the study was to evaluate the influence of endometriosis on various aspects of ART, including oocyte competence, ART success, and whether surgical or medical treatments improve these.</p><p><strong>Methods: </strong>We primarily focused on recent high-quality sources, including systematic reviews, large-scale observational studies, and meta-analyses, to provide a robust and reliable synthesis of the available evidence.</p><p><strong>Outcome: </strong>While oocyte yield can decrease in the presence of an endometrioma or history of endometrioma excision, oocyte quality, early embryo development indicators, aneuploidy rates, and clinical outcomes of endometriosis patients do not differ from other infertility diagnoses in ART setting. Surgical treatments and hormonal suppression before ART do not seem to improve outcomes. Ovarian stimulation for ART does not exacerbate endometriosis symptoms.</p><p><strong>Conclusions and outlook: </strong>Endometriosis, despite its high prevalence among infertile patients, does not inherently impair ART success, except in cases where ovarian reserve is compromised due to ovarian disease or its surgical treatment. The causal link between endometriosis and infertility remains an enigma, and future studies should continue to explore this association with other confounding factors.</p>","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"374-380"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Circ_0043314 Modulates Proliferation and Apoptosis of Ovarian Granulosa Cells in Polycystic Ovarian Syndrome via the MicroRNA-146b-3p/Apelin 13 Axis.","authors":"Wei Wang, Luni Tan, Liang Ge, Ruiqiang Gou, Li Gou, Lin Liu, Lili Zhang, Xiaoling Ma","doi":"10.1159/000540097","DOIUrl":"10.1159/000540097","url":null,"abstract":"<p><strong>Introduction: </strong>Polycystic ovary syndrome (PCOS) is a common endocrine and metabolic disorder in women. At present, the pathogenesis has not been clarified, and the clinical application of drugs and lifestyle intervention may not prevent disease progression. This study aimed to investigate how circ_0043314 regulates ovarian granulosa cell biological functions to provide a theoretical basis for the treatment of patients with PCOS. MicroRNA (miR)-146b-3p/Apelin 13 axis was used to investigate the mechanism by which circ_0043314 regulated ovarian granulosa cell proliferation and apoptosis in PCOS via miR-146b-3p/Apelin 13 axis. Participants/Materials, Methods: Ovarian tissues (cortical tissues) from 35 PCOS patients and 35 normal controls, as well as HEK293T and human ovarian granulosa cell line (KGN, COV434), were included in this study. We examined the expression levels of circ_0043314, miR-146b-3p, and Apelin 13 in PCOS tissues. Ovarian granulosa cells were transfected with corresponding plasmids to clarify the influence of circ_0043314, miR-146b-3p, or Apelin 13 on proliferation and apoptosis of ovarian granulosa cells through MTT and flow cytometry assays. Moreover, the relationships among circ_0043314, miR-146b-3p, and Apelin 13 were analyzed through dual-luciferase and RNA immunoprecipitation assays.</p><p><strong>Results: </strong>Circ_0043314 and Apelin 13 were highly expressed and miR-146b-3p was lowly expressed in ovarian tissues of PCOS compared with non-PCOS controls. Downregulation of circ_0043314 or upregulation of miR-146b-3p hindered ovarian granulosa cell proliferation and advanced its apoptosis. Downregulation of miR-146b-3p reversed the impacts of downregulation of circ_0043314, and overexpression of Apelin 13 counteracted the influences of upregulation of miR-146b-3p in ovarian granulosa cells. Mechanically, circ_0043314 could bind to miR-146b-3p, and miR-146b-3p directly targeted and modulated Apelin 13 expression.</p><p><strong>Limitations: </strong>This study was limited by the lack of animal experiments.</p><p><strong>Conclusion: </strong>Our data demonstrated that circ_0043314 enhances ovarian granulosa cell proliferation and suppresses its apoptosis via miR-146b-3p/Apelin 13 axis.</p>","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"18-29"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141619860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Immune Checkpoint Inhibitors Combined with Chemotherapy or Tyrosine Kinase Inhibitors in Advanced Endometrial Cancer: A Systematic Review and Meta-Analysis.","authors":"Yuting Li, Shixiu Li, Juan Liang","doi":"10.1159/000541617","DOIUrl":"10.1159/000541617","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this meta-analysis was to conduct a comprehensive assessment of the therapeutic effectiveness and safety profile of the combination of immune checkpoint inhibitors (ICIs) with either chemotherapy or tyrosine kinase inhibitors (TKIs) in the treatment of advanced-stage endometrial cancer (EC).</p><p><strong>Methods: </strong>This meta-analysis conducted a thorough literature search across PubMed, Cochrane Library, Embase, and Web of Science databases from their earliest records up to November 18, 2023, identifying qualified randomized controlled trials (RCTs), cohort studies, and single-arm trials for inclusion in the analysis. The meta-analysis were performed to quantify and analyzed the evidence from the existing literature, focusing on outcomes including the objective response rate (ORR), disease control rate (DCR), duration of response, overall survival (OS), progression-free survival (PFS), and adverse events (AEs).</p><p><strong>Results: </strong>A total of 13 studies were included. In terms of ICI combined with chemotherapy, the single-arm trials showed that ICI combined with chemotherapy was effective in improving the ORR, but the overall rate of AE was higher. The results based on RCT suggested that ICI combined with chemotherapy resulted in a longer PFS of 12-24 months and OS of 18 months compared to the control group in advanced EC. In terms of ICI combined with TKI, the pooled ORR was 39.0%, the pooled DCR was 79.9%, the pooled OS rate was 50.4%, and the pooled overall AE rate was 95.8%, the pooled grade ≥3 AE rate was 73.8%, the pooled median progression-free survival was 6.126 months, and pooled OS was 15.099 months in advanced EC.</p><p><strong>Conclusions: </strong>The integrative therapeutic approach combining ICIs with chemotherapy or TKIs demonstrates notable clinical efficacy in advanced EC, which can prolong the survival and help disease control. Nevertheless, it is imperative for clinicians to be vigilant regarding the potential for adverse reactions to emerge. In addition, more RCTs are needed to solidify this study's efficacy and safety further.</p>","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"241-254"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142575998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}