紫杉醇/白蛋白紫杉醇为基础的化疗联合PD-1/PD-L1抑制剂治疗三阴性乳腺癌的疗效和安全性:荟萃分析  

Efficacy and safetyof paclitaxel/albuminpaclitaxel based chemotherapy combined withPD-1/PD-L1 inhibitorsintriple-negativebreastcancer:aMeta-analysis

作　　者：张彬月 贾红燕[2] Zhang Binyue;Jia Hongyan(First Clinical Medical College,Shaanxi Medical University,Taiyuan Shaaxi Province 030001,China;Department of Mammary Gland,The First hospital of Shaanxi Medical University,Taiyuan Shaaxi Province 030001,China)

机构地区：[1]山西医科大学第一临床医学院,太原030001 [2]山西医科大学第一医院乳腺科,太原030001

出　　处：《中华普外科手术学杂志（电子版）》2023年第1期52-58,共7页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：山西省自然科学基金面上项目(201901D111347);山西省留学人员科技活动择优资助项目(20200036);山西省回国留学人员科研资助项目(2021-157)。

摘　　要：目的探讨以紫杉醇/白蛋白紫杉醇为主体的化疗方案联合程序性死亡受体-1(PD-1)/程序性死亡受体-配体1(PD-L1)抑制剂在治疗三阴性乳腺癌(TNBC)的疗效及安全性。方法检索国内外数据库,检索时限均从数据库建库起至2021年12月9日。根据纳人及排除标准选择接受治疗的TNBC患者,试验组方案为PD-1/PD-L1抑制剂联合以紫杉醇/白蛋白紫杉醇为基础的化疗,对照组方案为安慰剂联合以紫杉醇/白蛋白紫杉醇为基础的化疗。采用RevMan5.4.1软件分析相关数据。通过异质性检验后,采用固定效应模型或随机效应模型进行Meta分析,通过漏斗图评价发表偏倚性。结果PD-1/PD-L1抑制剂联合以紫杉醇/白蛋白紫杉醇为基础的化疗试验组,其总生存率(OS)显著长于安慰剂联合化疗的对照组(P<0.05);在无进展生存期(PFS)及客观缓解率(ORR)方面,试验组也均优于对照组(P<0.05);试验组中出现治疗相关不良反应(TRAE)患者人数高于对照组(P<0.05)PD-L1受体阳性的TNBC患者中,在OS及PFS方面,试验组均优于对照组。结论接受PD-1/PD-L1抑制剂治疗联合紫杉醇/白蛋白紫杉醇为基础的TNBC化疗患者OS、PFS、ORR方面均有显著改善。ObjectiveToinvestigatetheefficacy yandsafetyofpaclitaxel/albumin-paclitaxel chemotherapy combined with programmed death receptor-1(PD-1)/Programmed death receptor-Ligand 1(PD-L1)inhibitors in the treatment of triple-negative breast cancer(TNBC).MethodsThe time limit for searching domestic and foreign databases is from the establishment of the database to December 9,2021.TNBC patients were selected to receive treatment according to inclusion and exclusion criteria.The experimental group was treated with PD-1/PD-L1 inhibitor combined with paclitaxel/albumin-paclitaxel based chemotherapy,and the control group was treated with placebo combined with paclitaxel/albumin-paclitaxel based chemotherapy.RevMan 5.4.1 software was used to analyze relevant data.After the heterogeneity test,the fixed effects model or random effects model was used for Meta-analysis,and the funnel plot was used to evaluate the publication bias.ResultsThe overall survival rate(OS)of PD-1/PD-LI inhibitor combined with paclitaxel/albumin-paclitaxel based chemotherapy group was significantly higher than that of placebo combined with chemotherapy group(P<0.05).In terms of progression-free survival(PFS)and objective response rate(ORR),experimental groups were also better than control groups(P<0.05).The number of patients with treatment-related adverse reactions(TRAE)in experimental group was higher than that in control group(P<0.05).In PD-L1 receptor positive TNBC patients,the experimental group was superior to the control group in terms of OS and PFS.ConclusionPatients receiving PD-1/PD-L1 inhibitor therapy combined with paclitaxel/albumin-paclitaxel based TNBC chemotherapy showed significant improvements in OS,PFS and ORR.

关 键 词：三阴性乳腺癌 程序性细胞死亡受体1 白蛋白结合型紫杉醇 Meta分析 

分 类 号：R737.9[医药卫生—肿瘤]