Meta-analysis of the efficacy and safety of Bruton's tyrosine kinase inhibitor in the treatment of mantle cell lymphoma
Objective To systematically evaluate the efficacy and safety of Bruton's yrosine kinase inhibitors(BTKi)in the treatment of mantle cell lymphoma(MCL).Methods English literatures on BTKi in treating MCL published in PubMed,Embase,The Cochrane Library,ClinicalTrials.gov and Web of Science from establishment to May 21st,2023 were selected.After two researchers independently screened the literatures,extracted the data and evaluated the risk of bias included in the study,the overall response rate(ORR)and the incidence of treatment-related adverse events(AEs)were used as outcome indicators to analyze the effectiveness and safety of BTKi in the treatment of MCL.Results A total of 4 818 articles were searched,and 15 articles were finally included,including two randomized controlled studies and 13 single-arm studies,with a total of 16 studies involving 1 029 patients.The meta-analysis results showed that the ORR of BTKi in the treatment of MCL was 83.7%(95%CI:76.7%-89.8%).Subgroup analysis showed that the combined reaction rate of each factors:younger group(age<65 years)was 91.4%(95%CI:70.6%-100.0%),older group(age≥65 years)was 80.7%(95%CI:76.0%-85.0%);treatment naive group was 94.5%(95%CI:81.0%-100.0%),relapsed/refractory group was 79.0%(95%CI:75.3%-82.5%);BTKi combination therapy group was 86.5%(95%CI:74.7%-95.3%),BTKi monotherapy group was 79.0%(95%CI:74.4%-83.3%);first-generation BTKi monotherapy group was 74.9%(95%CI:65.7%-83.2%),second-generation BTKi monotherapy group was 81.7%(95%CI:77.4%-85.7%);IR regimen(ibrutinib + rituximab)group was 93.2%(95%CI:80.0%-99.9%),non-IR regimen group was 77.4%(95%CI:69.6%-84.4%).In terms of safety,eight types of AEs were analyzed,with a higher incidence of thrombocytopenia(29.8%,95%CI:18.9%-42.0%)in hematological AEs and a higher incidence of fatigue(53.6%,95%CI:35.4%-71.4%)and diarrhea(48.1%,95%CI:35.1%-61.2%)in non-hematological AEs.Conclusions BTKi is effective and safe in the treatment of MCL,and the response rate is high when the age is less than 65 years old,the disease state is treatment naive,BTKi combined treatment,second-generation BTKi monotherapy and combined treatment IR regimen.
NETL
NSTL
万方数据
