Marko Skelin, Kaja Matić, Andrea Anić-Matić, Ivan Krečak, Bruna Perkov-Stipičin, Mirko Grubor
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引用次数: 0
摘要
间皮瘤预后差，5年总生存率（OS）小于5%。免疫疗法已被证明是一线治疗中铂基疗法的一种有希望的替代疗法。我们系统的文献检索包括7个随机临床试验，涉及2,549例患者，以评估免疫治疗对不同治疗线、组织学亚型和ECOG表现状态的OS的影响，并评估OS、无进展生存期（PFS）和客观反应率（ORR）之间的相关性。免疫治疗显著改善OS (HR 0.78, P = 0.0005)，在一线和二线/二线治疗中观察到类似的益处（P = 0.25）以及所有ECOG状态（P = 0.32）。与上皮样间皮瘤相比，非上皮样间皮瘤的获益明显更大（P = 0.002）。此外，只有OS和PFS之间有很强的相关性（r = 0.86, P = 0.01）。我们的研究结果强调了免疫治疗在间皮瘤中的重要性，并进一步支持PFS作为替代终点。
Immunotherapy in mesothelioma - systematic review and meta-analysis of immunotherapy impact on OS and its correlation with PFS and ORR.
Mesothelioma has a poor prognosis, with a 5-year overall survival (OS) rate less than 5%. Immunotherapy has been proven as a promising alternative to platinum-based therapies in first-line treatment. Our systematic literature search included 7 randomized clinical trials involving 2,549 patients to evaluate the impact of immunotherapy on OS across different lines of therapy, histologic subtypes, and ECOG performance status, and to assess the correlation between OS, progression-free survival (PFS), and objective response rate (ORR). Immunotherapy significantly improved OS (HR 0.78, P = 0.0005) with a similar benefit observed in first-line and second/later-line treatment (P = 0.25) as well as in all ECOG statuses (P = 0.32). A significantly greater benefit was observed in non-epithelioid compared to epithelioid mesothelioma (P = 0.002). Additionally, a strong correlation was shown only between OS and PFS (r = 0.86, P = 0.01). Our results emphasize the importance of immunotherapy in mesothelioma and further support PFS as a surrogate endpoint.
期刊介绍：
The Journal of Chemotherapy is an international multidisciplinary journal committed to the rapid publication of high quality, peer-reviewed, original research on all aspects of antimicrobial and antitumor chemotherapy.
The Journal publishes original experimental and clinical research articles, state-of-the-art reviews, brief communications and letters on all aspects of chemotherapy, providing coverage of the pathogenesis, diagnosis, treatment, and control of infection, as well as the use of anticancer and immunomodulating drugs.
Specific areas of focus include, but are not limited to:
· Antibacterial, antiviral, antifungal, antiparasitic, and antiprotozoal agents;
· Anticancer classical and targeted chemotherapeutic agents, biological agents, hormonal drugs, immunomodulatory drugs, cell therapy and gene therapy;
· Pharmacokinetic and pharmacodynamic properties of antimicrobial and anticancer agents;
· The efficacy, safety and toxicology profiles of antimicrobial and anticancer drugs;
· Drug interactions in single or combined applications;
· Drug resistance to antimicrobial and anticancer drugs;
· Research and development of novel antimicrobial and anticancer drugs, including preclinical, translational and clinical research;
· Biomarkers of sensitivity and/or resistance for antimicrobial and anticancer drugs;
· Pharmacogenetics and pharmacogenomics;
· Precision medicine in infectious disease therapy and in cancer therapy;
· Pharmacoeconomics of antimicrobial and anticancer therapies and the implications to patients, health services, and the pharmaceutical industry.
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