免疫检查点抑制剂联合化疗或酪氨酸激酶抑制剂治疗晚期子宫内膜癌的疗效和安全性:系统综述与荟萃分析。

IF 2 4区 医学 Q2 OBSTETRICS & GYNECOLOGY
Yuting Li, Shixiu Li, Juan Liang
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引用次数: 0

摘要

研究目的本荟萃分析旨在全面评估免疫检查点抑制剂(ICIs)与化疗或酪氨酸激酶抑制剂(TKIs)联合治疗晚期子宫内膜癌(EC)的疗效和安全性:这项荟萃分析在PubMed、Cochrane图书馆、Embase和Web of Science数据库中进行了全面的文献检索,从最早的记录到2023年11月18日,确定了合格的随机对照试验(RCT)、队列研究和单臂试验纳入分析。荟萃分析对现有文献中的证据进行量化和分析,重点关注客观反应率(ORR)、疾病控制率(DCR)、反应持续时间(DOR)、总生存期(OS)、无进展生存期(PFS)和不良事件(AE)等结果:结果:共纳入 13 项研究。在 ICI 联合化疗方面,单臂试验显示 ICI 联合化疗能有效提高 ORR,但 AE 的总发生率较高。基于RCT的结果表明,与对照组相比,ICI联合化疗可使晚期EC的PFS延长12-24个月,OS延长18个月。ICI联合TKI治疗晚期EC的总ORR为39.0%,总DCR为79.9%,总OS为50.4%,总AE为95.8%,总≥3级AE为73.8%,总中位无进展生存期(mPFS)为6.126个月,总OS为15.099个月:结论:将 ICIs 与化疗或 TKIs 相结合的综合治疗方法在晚期 EC 中具有显著的临床疗效,可延长生存期并有助于疾病控制。然而,临床医生必须对可能出现的不良反应保持警惕。此外,还需要更多的研究试验来进一步巩固这项研究的疗效和安全性。
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 Immune Checkpoint Inhibitors Combined with Chemotherapy or Tyrosine Kinase Inhibitors in Advanced Endometrial Cancer: A Systematic Review and Meta-Analysis.

Objective: 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).

Methods: 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).

Results: 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.

Conclusions: 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.

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来源期刊
CiteScore
4.20
自引率
4.80%
发文量
44
审稿时长
6-12 weeks
期刊介绍: This journal covers the most active and promising areas of current research in gynecology and obstetrics. Invited, well-referenced reviews by noted experts keep readers in touch with the general framework and direction of international study. Original papers report selected experimental and clinical investigations in all fields related to gynecology, obstetrics and reproduction. Short communications are published to allow immediate discussion of new data. The international and interdisciplinary character of this periodical provides an avenue to less accessible sources and to worldwide research for investigators and practitioners.
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