PD-1/PD-L1抑制剂联合化疗对比化疗一线治疗晚期非小细胞肺癌疗效及安全性的Meta分析  

Comparison in treatment efficacy and safety between PD-1/PD-L1 inhibitor combined with chemotherapy and chemotherapy alone as first-line treatment for advanced NSCLC: A Meta-analysis

作　　者：霍庚崴 宋莹 贾沙沙 陈卫东[1] HUO Gengwei;SONG Ying;JIA Shasha;CHEN Weidong(Department of Oncology,First People’s Hospital of Jining City,Jining 272000,Shandong,China;Department of Pharmacy,First People’s Hospital of Jining City,Jining 272000,Shandong,China)

机构地区：[1]济宁市第一人民医院肿瘤科,山东济宁272000 [2]济宁市第一人民医院药剂科,山东济宁272000

出　　处：《中国肿瘤生物治疗杂志》2020年第3期309-314,共6页Chinese Journal of Cancer Biotherapy

摘　　要：目的:系统评价PD-1/PD-L1抑制剂联合化疗对比化疗一线治疗晚期非小细胞肺癌(non-small lung cancer,NSCLC)的疗效及安全性。方法:检索PubMed、Cochrane Library、EMbase、EBSCO循证医学数据库、中国生物医学文献数据库(Chinese Biomedical Literature Database,CBM)、中国知网(Chinese Journal Full-text Database,CNKI)、中文科技期刊全文数据库(VIP)中收录的PD-1/PD-L1抑制剂联合化疗对比化疗一线治疗晚期NSCLC的随机对照试验(randomized controlled trials,RCTs),采用RevMan 5.2软件进行Meta分析。结果:纳入6个临床RCTs共3 238例晚期NSCLC。Meta分析结果显示,PD-1/PD-L1抑制剂联合化疗与化疗相比可显著延长OS(HR=0.86,95%CI=0.79~0.94,P=0.0006)和PFS(HR=0.81,95%CI=0.78~0.84,P<0.00001);1~5级血小板计数减少、呕吐、腹泻、甲状腺功能减低或亢进、皮疹、肺炎、结肠炎、肝炎、味觉障碍,3~5级肝炎的不良反应发生率较化疗组高,差异具有统计学意义(P<0.01或P<0.05)。结论:PD-1/PD-L1抑制剂联合化疗较单独化疗一线治疗晚期NSCLC可显著延长患者OS和PFS,但不良反应发生率较化疗高。Objective: To systematically evaluate the efficacy and safety of PD-1/PD-L1 inhibitor combined with chemotherapy as comparing with chemotherapy alone for the first-line treatment of advanced NSCLC(non-small lung cancer). Methods: RCTs(randomized controlled trials) on PD-1/PD-L1 inhibitor combined with chemotherapy compared with chemotherapy alone for the first-line treatment of advanced NSCLC were searched in the PubMed, Cochrane Library, EMbase, EBSCO, Chinese Biomedical Literature Database(CBM), Chinese Journal Full-text Database(CNKI), and Chinese Scientific Journal Full-text Database(VIP). RevMan 5.2 software was used for the Meta-analysis. Results: Six RCTs with 3 238 advanced NSCLC patients were included in this study. Meta-analysis showed that the combination therapy group was more effective than the chemotherapy alone group in OS(HR=0.86, 95%CI=0.79~0.94, P=0.0006) and PFS(HR=0.81, 95%CI=0.78~0.84, P<0.00001). The incidence of adverse reactions, such as thrombocytopenia of grade 1-5, vomiting, diarrhea, hypothyroidism, hyperthyroidism, rash, pneumonitis, colitis, hepatitis, dysgeusia, hepatitis of grade 3-5 and colitis, in combined treatment group were all higher than those in chemotherapy alone group, the differences were statistically significant(P<0.01 or P<0.05). Conclusions: Compared with chemotherapy alone, PD-1/PD-L1 inhibitor combined with chemotherapy can significantly improve the OS and PFS of patients with advanced NSCLC in the first-line treatment, while the overall incidence of adverse reactions is higher than chemotherapy.

关 键 词：非小细胞肺癌 PD-1/PD-L1抑制剂 化疗 程序性死亡受体-1 程序性死亡-配体1 

分 类 号：R734.2[医药卫生—肿瘤] R730.5[医药卫生—临床医学]