目的:对阿替利珠单抗治疗肝细胞癌的系统评价/Meta分析进行再评价.方法:检索PubMed、Web of Science、Cochrane Library、中国知网、维普和万方数据库自建库至2023年4月13日阿替利珠单抗治疗肝细胞癌的系统评价/Meta分析.筛选文献、提取数据后,分别采用PRISMA声明、AMSTAR 2量表和GRADE系统评价纳入研究的报告质量、方法学质量和证据质量.结果:最终纳入7篇文献,共19个结局指标,PRISMA声明评价结果显示7篇研究均完全报告的条目只有8个;AMSTAR 2量表评价结果显示条目2和条目7这两个关键条目的缺失决定7篇研究方法学质量均为极低;GRADE系统评价结果显示19个结局指标中,只有3个的证据质量是高质量,局限性和不一致降低了其余16个结局指标的证据质量.在有效性方面,阿替利珠单抗能提高总生存期、无进展生存期和客观总缓解率.在安全性方面,纳入研究不良事件数据分歧明显.结论:阿替利珠单抗治疗肝细胞癌的有效性显著,但安全性还有待考证.
Efficacy and safety of attilizumab in the treatment of hepatocellular carcinoma:an overview of systematic reviews
OBJECTIVE To re-evaluate the systematic reviews and Meta-analyses of atezolizumab in the treatment of hepa-tocellular carcinoma(HCC).METHODS The systematic reviews and Meta-analyses of atezolizumab in the treatment of HCC were retrieved from the databases of PubMed,Web of Science,Cochrane Library,CNKI,VIP and Wanfang until April 13,2023.After literature screening and data extraction,PRISMA,AMSTAR 2 and GRADE were utilized for evaluating the report-ing quality,methodological quality and evidence quality of the included studies.RESULTS A total of 7 systematic reviews and Meta-analyses with 19 outcomes were obtained.The evaluation results of PRISMA showed that only 8 items were fully reported in 7 studies.According to AMSTAR 2,the methodological quality of 7 research papers was rather low due to a lack of two key items,i.e.item 2 and item 7.The results of GRADE evaluation showed that only 3/19 outcome indicators had high-quality evi-dence while study limitations and inconsistency reduced the quality of evidence for the remaining 16 outcome indicators.In terms of effectiveness,atezolizumab could boost the levels of overall survival(OS),progression-free survival(PFS)and objective response rate(ORR).In terms of safety,adverse event data differed greatly.CONCLUSION The efficacy of atezolizumab is definite in the treatment of HCC.However,the safety should be further verified.
atezolizumabhepatocellular carcinomaoverview of systematic review
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