PD-1/PD-L1抑制剂不同联合方案治疗晚期卵巢癌的疗效和不良反应的meta分析
Meta-analysis of efficacy and adverse effects of different combination schemes of PD-1/PD-L1 inhibitors in the treatment of ovarian cancer
张倩 1徐志宏1
作者信息
- 1. 河北医科大学第四医院肿瘤内科,石家庄 050000
- 折叠
摘要
目的 探究程序性细胞死亡蛋白1(PD-1)/程序性细胞死亡蛋白1配体(PD-L1)抑制剂不同联合方案用于晚期卵巢癌后线治疗的疗效和不良反应.方法 通过检索Pubmed、Embase和Cochrane library文献库,收集截至2023年11月关于PD-1/PD-L1免疫抑制剂联合不同策略治疗卵巢癌的文献,对其进行质量评估和数据提取,采用Revman 5.3及Stata 15.0软件进行荟萃分析.结果 最终纳入11项单臂研究.荟萃分析结果显示,PD-1/PD-L1抑制剂联合不同方案[化疗药物、聚腺苷二磷酸核糖聚合酶(PARP)抑制剂和抗血管靶向药物]治疗晚期卵巢癌在临床上获益,客观缓解率为24％.因异质性为60％,对其原因进行亚组分析,结果显示,PD-1/PD-L1抑制剂联合抗血管靶向药物在治疗晚期卵巢癌的客观缓解率为25％,疾病控制率为60％;联合抗血管靶向药物的客观缓解率为64％;PD-1/PD-L1抑制剂联合不同药物治疗6个月的无进展生存率为43％,12个月的无进展生存率为26％,12个月的总生存率为79％.3～5级不良反应的发生率为28％,以高血压、恶心、贫血最为多见.结论 PD-1/PD-L1抑制剂联合不同方案治疗晚期卵巢癌明显改善患者的生存和预后,且不良反应多可耐受.
Abstract
Objective To investigate the efficacy and side effects of different combined strategies of programmed cell death protein 1(PD-1)/programmed cell death protein 1 ligand(PD-L1)inhibitors in the treatment of advanced ovarian cancer.Methods By searching Pubmed,Embase and Cochrane library,literature on PD-1/PD-L1 immunosuppressants combined with different strategies for ovarian cancer up to November 2023 was collected for quality assessment and data extraction.The meta-analysis was performed using Revman 5.3 and Stata 15.0 software.Results Eleven single-arm studies were included.The results of meta-analysis showed that PD-1/PD-L1 inhibitors combined with different regimens[chemotherapy agents,polyadenosine diphosphoribose polymerase(PARP)inhibitors,and anti-vascular targeting agents]in the treatment of advanced ovarian cancer were clinically beneficial,with an objective response rate of 24％.The heterogeneity was 60％,and the causes were analyzed by subgroups.The results showed that the objective remission rate of PD-1/PD-L1 inhibitor combined with anti-vascular targeted drugs in the treatment of advanced ovarian cancer was 25％,and the disease control rate was 60％.The objective response rate of combined anti-vascular targeting drugs was 64％.Treatment with PD-1/PD-L1 inhibitors combined with different drugs had a progression-free survival rate of 43％at 6 months,26％at 12 months,and 79％overall at 12 months.The incidence of grade 3～5 adverse reactions was 28％,with hypertension,nausea and anemia being the most common.Conclusions PD-1/PD-L1 inhibitors combined with different regiments in the treatment of advanced ovarian cancer significantly improved the survival and prognosis of patients.And the incidence of adverse reactions is considerable.
关键词
卵巢癌/贝伐珠单抗/聚腺苷二磷酸核糖聚合酶抑制剂/免疫检查点抑制剂/疗效/安全性/meta分析Key words
ovarian cancer bevacizumab/PARP inhibitors/immune checkpoint inhibitors/efficacy safety/meta-analysis引用本文复制引用
出版年
2024
NETL
NSTL
万方数据