卡瑞利珠单抗联合阿帕替尼治疗原发性肝癌有效性及安全性的Meta分析  

Meta-analysis of the efficacy and safety of camrelizumab combined with apatinibin the treatment of primary liver cancer

作　　者：于豫鄂 方祝君 伊晓娇 余彩龙 李婷[1] 包剑锋 YU Yu’e;FANG Zhujun;YI Xiaojiao;YU Cailong;LI Ting;BAO Jianfeng(Department of Pharmacy,Affiliated Hangzhou Xixi Hospital,Zhejiang University School of Medicine,Hangzhou 310023,Zhejiang,China;Department of Clinical Pharmacy,the First Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou 310003,Zhejiang,China;Department of Scientific Research and Education,Affiliated Hangzhou Xixi Hospital,Zhejiang University School of Medicine,Hangzhou 310023,Zhejiang,China)

机构地区：[1]浙江大学医学院附属杭州市西溪医院药学部,浙江杭州310023 [2]浙江大学医学院附属第一医院临床药学室,浙江杭州310003 [3]浙江大学医学院附属杭州市西溪医院科研教学部,浙江杭州310023

出　　处：《中国现代医生》2023年第23期73-78,83,共7页China Modern Doctor

基　　金：杭州市生物医药和健康产业发展扶持科技及专项(2021WJCY06)。

摘　　要：目的 系统评价卡瑞利珠单抗联合阿帕替尼在原发性肝癌中的有效性及安全性。方法 检索PubMed、Cochrane Library、Embase、中国知网、维普、万方数据库与卡瑞利珠单抗联合阿帕替尼治疗原发性肝癌相关的所有研究,时间限定为建库至2022年7月31日。采用Stata12.0软件对卡瑞利珠单抗联合阿帕替尼治疗原发性肝癌的整体有效性和安全性进行系统评价。结果 共纳入8篇文献10项研究,包含560例患者。卡瑞利珠单抗联合阿帕替尼治疗原发性肝癌的客观缓解率为29.0%[95%置信区间(confidenceinterval,CI):0.22~0.37,P<0.001]、疾病控制率为72.0%(95%CI:0.67~0.77,P<0.001)、中位无进展生存期为7.1个月(95%CI:5.51~8.69,P<0.001)、12个月生存率为45.59%(95%CI:16.60%~74.58%,P<0.01)、腹泻发生率为30.0%(95%CI:0.25~0.35,P<0.001)、3级及以上腹泻发生率为2.0%(95%CI:0.01~0.04,P<0.01)。所有级别的不良反应比较,差异均有统计学意义(P<0.05);3级及以上的不良反应中,腹痛、手足综合征、血小板减少、白细胞减少、蛋白尿比较,差异有统计学意义(P<0.05),其余无统计学意义。结论 卡瑞利珠单抗联合阿帕替尼治疗原发性肝癌疗效确切,不良反应发生率低,为原发性肝癌的治疗提供参考。Objective To investigate the efficacy and safety of camrelizumab combined with apatinib for primary liver cancer.Methods PubMed,Cochrane Library,Embase,CNKI,VIP,Wanfang were searched for English and Chinese study reports on camrelizumab and apatinib for primary liver cancer.The search period was from the establishment of the database to July 31,2022.Stata 12.0 software was used to perform a Meta-analysis of the extracted date.Results A total of 8 literatures and 10 studies were included in this study,with a total of 560 cases with primary liver cancer.The Meta-analysis showed that the objective response rate was 29.0%[95%(confidence interval,CI):0.22-0.37,P<0.001),disease control rate was 72.0%(95%CI:0.67-0.77,P<0.001),median progression-free survival was 7.1 months(95%CI:5.51-8.69,P<0.001),12-month overall survival rate was 45.59%(95%CI:16.60%-74.58%,P<0.01),all grades of diarrhea rate was 30.0%(95%CI:0.25-0.35,P<0.001),diarrhea rate of grade≥3 was 2.0%(95%CI:0.01-0.04,P<0.01).All grades of adverse events were statistically significant,the adverse events of the grade≥3 were statistically significant with abdominal pain,hand-foot syndrome,thrombocytopenia,leukopenia,and proteinuria.Conclusion For patients with primary liver cancer,camrelizumab in combination with apatinib can achieve controllable safety and good efficacy,thereby providing a treatment option with clinical benefits.

关 键 词：卡瑞利珠单抗 阿帕替尼 原发性肝癌 META分析 

分 类 号：R735.7[医药卫生—肿瘤]