免疫检查点抑制剂治疗晚期胃癌或食管胃结合部癌的有效性和安全性Meta分析  

Efficacy and Safety of Immune Checkpoint Inhibitors Therapy on Advanced Gastric Cancer or Gastroesophageal Junction Cancer:A Meta-analysis

作　　者：单玉洁[1] 梁平[2] 吕雅蕾[1] 王龙[1] 张晓琳[3] 单保恩[4] SHAN Yujie;LIANG Ping;LYU Yalei;WANG Long;ZHANG Xiaolin;SHAN Baoen(Department of Medical Oncology,Fourth Hospital of Hebei Medical University,Shijiazhuang 050011,China;Department of Pharmacy,Fourth Hospital of Hebei Medical University,Shijiazhuang 050011,China;Department of Statistics,Hebei Medical University,Shijiazhuang 050017,China;Scientific Research Center,Fourth Hospital of Hebei Medical University,Shijiazhuang 050011,China)

机构地区：[1]河北医科大学第四医院肿瘤内科,石家庄050011 [2]河北医科大学第四医院药学部,石家庄050011 [3]河北医科大学统计教研室,石家庄050017 [4]河北医科大学第四医院科研中心,石家庄050011

出　　处：《肿瘤防治研究》2021年第2期166-172,共7页Cancer Research on Prevention and Treatment

基　　金：河北省卫生厅2018年“医学科学研究重点课题计划”(20180545)。

摘　　要：目的系统评价免疫检查点抑制剂治疗晚期GC/GEJC患者的疗效及安全性。方法通过计算机检索CNKI、万方、PubMed、EMBASE、ClinicalTrials、Cochrane Library等数据库收集免疫检查点抑制剂治疗晚期GC/GEJC的临床试验,检索时间从建库至2019年11月,结局指标主要包括客观缓解率、疾病控制率、无进展生存期、总生存期以及安全性;采用率差和风险比为效应量,采用RevMan5.3软件进行Meta分析。结果共纳入7篇文献1949例患者。结果显示:晚期GC/GEJC患者≥二线免疫检查点抑制剂治疗比化疗/安慰剂治疗提高了患者12月和18月的总生存率(均P<0.05),延长了患者的总生存期(P<0.05)。免疫检查点抑制剂治疗引起的任何级别或≥3级不良反应的发生率均低于化疗/安慰剂治疗。结论免疫检查点抑制剂治疗可改善部分晚期GC/GEJC患者生存终点,且常见不良反应发生率较低。Objective To systematically evaluate the efficacy and safety of immune checkpoint inhibitors in the treatment of advanced gastric cancer or gastroesophageal junction cancer(GC/GEJC).Methods CNKI,Wanfang,PubMed,EMBASE,ClinicalTrials,Cochrane Library and other databases were searched to collect the clinical trials of immune checkpoint inhibitors in the treatment of advanced GC/GEJC.The retrieval time was from the inception to Nov.2019.Outcome measures mainly included ORR,DCR,PFS,OS and toxicities.The adoption rate difference and hazard ratio were effect measures.Meta-analysis was performed using RevMan 5.3 software.Results We included seven literatures with a total of 1949 patients.Meta-analysis showed that for the patients with advanced GC/GEJC,the second-line or later immune checkpoint inhibitor therapy improved the overall survival rate at 12 and 18 months;the OS of the patients was prolonged,compared with chemotherapy/placebo therapy(all P<0.05).The incidence of adverse reactions of any grade or≥grade 3 caused by immune checkpoint inhibitor therapy was lower than that caused by chemotherapy/placebo.Conclusion Immune checkpoint inhibitor treatment could improve survival endpoints in some patients with advanced GC/GEJC,and the incidence of common adverse reactions is low.

关 键 词：晚期胃癌 晚期食管胃结合部癌 免疫检查点抑制剂 化疗 安慰剂 有效性 安全性 META分析 

分 类 号：R735.2[医药卫生—肿瘤]