可切除非小细胞肺癌围手术期免疫疗法组合的疗效和安全性:系统综述和网络荟萃分析。

IF 4.6 2区 医学 Q2 IMMUNOLOGY
Yuelin Han, Xiangtian Xiao, Tingting Qin, Shuxi Yao, Xinyue Liu, Yanqi Feng, Zhou Li, Yiming Li, Shu Xia
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引用次数: 0

摘要

简介:可切除的非小细胞肺癌(NSCLC)围手术期免疫疗法对可切除的非小细胞肺癌(NSCLC)进行围手术期免疫治疗的几项试验都取得了积极的结果。这些试验设计了辅助、新辅助和夹心(新辅助加辅助)免疫疗法与免疫检查点抑制剂和化疗(CT)。新辅助和三明治模式之间的差异尚不明确:我们从 PubMed、EMBASE、Cochrane Library、Web of Science、ClinicalTrials.gov、WHO ICTRP 和主要国际会议中检索了相关文献,进行了系统综述和贝叶斯网络荟萃分析:我们分析了涉及3429名患者的8项研究,包括6项新辅助加辅助(Neo-Adj)和2项新辅助(Neo)试验。与CT相比,Neo-Adj的无事件生存期(EFS)更好(危险比[HR] = 0.57,95%置信区间[CI]:0.45-0.71)。Neo-Adj 和 Neo 在无事件生存期(HR = 0.87,95% CI:0.53-1.46)和总生存期(OS)(HR = 1.04,95% CI:0.38-2.57)方面没有差异。PD-L1≥50%的亚组分析表明,Neo-Adj的EFS(HR = 0.46,95% CI:0.27-0.76)和Neo(HR = 0.24,95% CI:0.06-0.89)优于CT,Neo-Adj可能导致EFS短于Neo(HR = 1.92,95% CI:0.46-7.84):我们的研究结果表明,Neo-Adj和Neo对PD-L1患者的EFS相似。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Efficacy and safety of perioperative immunotherapy combinations for resectable non-small cell lung cancer: a systematic review and network meta-analysis.

Introduction: Several trials of perioperative immunotherapy for resectable non-small cell lung cancer (NSCLC) reported positive results. They were designed to adjuvant, neoadjuvant and sandwich (neoadjuvant plus adjuvant) immunotherapy with immune checkpoint inhibitors and chemotherapy (CT). The differences between neoadjuvant and sandwich modalities were unclear.

Method: We performed a systematic review and Bayesian network meta-analysis by retrieving relevant literature from PubMed, EMBASE, Cochrane Library, Web of Science, ClinicalTrials.gov, WHO ICTRP and major international conferences.

Results: We analyzed 8 studies involving 3429 patients, including 6 neoadjuvant plus adjuvant (Neo-Adj) and 2 neoadjuvant (Neo) trials. Neo-Adj had better event-free survival (EFS) (hazard ratio [HR] = 0.57, 95% confidence interval [CI]: 0.45-0.71) than CT. There existed no difference between Neo-Adj and Neo in EFS (HR = 0.87, 95% CI: 0.53-1.46) and overall survival (OS) (HR = 1.04, 95% CI: 0.38-2.57). Neo might have lower incidence of treatment-related adverse events (TRAEs) (relative risk [RR] = 0.96, 95% CI: 0.87-1.12) than Neo-Adj. Subgroup analysis of PD-L1 ≥ 50% suggested that EFS of Neo-Adj (HR = 0.46, 95% CI: 0.27-0.76) and Neo (HR = 0.24, 95% CI: 0.06-0.89) was better than CT, and Neo-Adj potentially caused shorter EFS than Neo (HR = 1.92, 95% CI: 0.46-7.84).

Conclusions: Our results suggest that Neo-Adj and Neo have similar EFS for patients with PD-L1 < 1% or 1-49%. However, patients with PD-L1 ≥ 50% may obtain more EFS benefit from Neo than Neo-Adj. Neo might present a more favorable assessment than Neo-Adj when evaluating OS. Moreover, adding adjuvant immunotherapy may increase toxicity.

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来源期刊
CiteScore
10.50
自引率
1.70%
发文量
207
审稿时长
1 months
期刊介绍: Cancer Immunology, Immunotherapy has the basic aim of keeping readers informed of the latest research results in the fields of oncology and immunology. As knowledge expands, the scope of the journal has broadened to include more of the progress being made in the areas of biology concerned with biological response modifiers. This helps keep readers up to date on the latest advances in our understanding of tumor-host interactions. The journal publishes short editorials including "position papers," general reviews, original articles, and short communications, providing a forum for the most current experimental and clinical advances in tumor immunology.
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