BRAF抑制剂联合或不联合MEK抑制剂治疗晚期BRAF阳性非小细胞肺癌:一项系统综述

IF 1 4区 医学 Q4 ONCOLOGY
Animesh Saha, T Raja, Amit Dutt Dwary, Indranil Ghosh, Prabrajya Narayan Mahapatra, Tanmoy Mukhopadhay
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引用次数: 0

摘要

目的:约1%至5%的非小细胞肺癌(NSCLC)病例被发现具有BRAF突变。尽管许多II期和回顾性研究已经证明了在接受治疗和未接受治疗的患者组中单药BRAF抑制和BRAF/MEK联合抑制的有效性,但没有III期数据。本系统综述的目的是对这方面的现有证据进行概述。数据来源:在PubMed, Medline, Embase和Cochrane数据库中对2000年1月至2023年12月期间发表的具有全文可访问性的英语论文进行了彻底的搜索。独立地,一位作者筛选了符合我们预定要求的合格研究。对定性数据进行了综合,并对研究的设计和质量进行了评估。数据汇总:使用检索方法共检索到2952篇文章。经过两轮筛选,纳入了12篇出版物,共753例患者。客观有效率(ORR)为33 ~ 75%。64 ~ 100%为疾病控制率(DCR)。答案的时间跨度从6.4个月到16.7个月不等。中位无进展生存期(PFS)为1.2至17.5个月。中位总生存期(OS)为1.7-25.5个月。当将BRAF单药抑制剂与BRAF + MEK抑制剂的研究结果进行比较时,前者的反应率、反应持续时间和生存率更好。当接受BRAF/MEK抑制剂治疗的未治疗患者与先前治疗的患者进行比较时,结果也有所改善。高血压、发热、低钠血症、中性粒细胞减少症、呼吸困难、贫血、肝功能异常、虚弱和皮肤表皮样癌是经常报道的≥3级毒性。结论:包括BRAF突变的晚期NSCLC患者在接受BRAF抑制剂治疗时,无论是联合还是不联合MEK抑制剂治疗,均显示出令人鼓舞的临床结果和可管理的安全性。对于以前未接受过治疗的患者,联合治疗效果更好。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
BRAF inhibitors with or without MEK inhibitors in advanced BRAF-positive non-small cell lung cancer: A systematic review.

Objective: About 1% to 5% of cases of non-small cell lung cancer (NSCLC) have been found to have a BRAF mutation. There is no phase III data, despite the fact that numerous phase II and retrospective studies have demonstrated the efficacy of single agent BRAF inhibition and combination BRAF/MEK inhibition in patient groups that have received treatment and those who have not. Our goal in this systematic review was to provide an overview of the available evidence in this context.

Data sources: A thorough search was conducted in the PubMed, Medline, Embase, and Cochrane databases for English-language papers published between January 2000 and December 2023 that had full text accessibility. Independently, one author screened the eligible studies that fit our predetermined requirements. A synthesis of the qualitative data was conducted, and the design and quality of the studies were evaluated.

Data summary: There were 2952 articles found using the search method. Twelve publications with a total of 753 patients were included after two rounds of screening. 33-75% was the objective response rate (ORR). 64-100% was the disease control rate (DCR). The time span for the answer varied from 6.4 to 16.7 months. The range of the median progression-free survival (PFS) was 1.2 to 17.5 months. The range of the median overall survival (OS) was 1.7-25.5 months. When comparing studies with single agent BRAF inhibitors to those reporting the results of BRAF plus MEK inhibitors, the response rates, duration of response, and survival were better in the former case. When untreated patients receiving BRAF/MEK inhibitor therapy were compared to previously treated patients, the results were also improved. Hypertension, pyrexia, hyponatremia, neutropenia, dyspnoea, anaemia, abnormal liver function, asthenia, and cutaneous epidermoid carcinoma were among the frequently reported grade ≥3 toxicity.

Conclusions: Patients with advanced NSCLC that include a BRAF mutation have demonstrated encouraging clinical outcomes with a manageable safety profile when treated with BRAF inhibitors, either in combination with or without MEK inhibitor therapy. In patients who had not received treatment before, combination treatment produced greater results.

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来源期刊
CiteScore
2.70
自引率
7.70%
发文量
276
期刊介绍: Journal of Oncology Pharmacy Practice is a peer-reviewed scholarly journal dedicated to educating health professionals about providing pharmaceutical care to patients with cancer. It is the official publication of the International Society for Oncology Pharmacy Practitioners (ISOPP). Publishing pertinent case reports and consensus guidelines...
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