三阴性乳腺癌的转移情况对阿替利珠单抗联合化疗疗效影响的Meta分析  

Correlation between the metastasis of triple-negative breast cancer and the efficacy of atezolizumab combined with chemotherapy:A meta-analysis

作　　者：马雨欣 施玥 石鑫红 姜莹莹 刘怡伶 卢麟 昌雨婷 周飞[1] 王晓华[1] 陈诚[1] 冯继锋[1] MA Yuxin;SHI Yue;SHI Xinhong;JIANG Yingying;LIU Yiling;LU Lin;CHANG Yuting;ZHOU Fei;WANG Xiaohua;CHEN Cheng;FENG Jifeng(Department of Oncology,the Affiliated Cancer Hospital of Nanjing Medical University/Jiangsu Cancer Hospital/Jiangsu Cancer Institute,Nanjing 210009,China)

机构地区：[1]南京医科大学附属肿瘤医院/江苏省肿瘤医院/江苏省肿瘤防治研究所肿瘤内科,江苏南京210009

出　　处：《中国肿瘤外科杂志》2023年第6期576-583,共8页Chinese Journal of Surgical Oncology

摘　　要：目的 探讨影响阿替利珠单抗联合化疗治疗转移性三阴性乳腺癌(mTNBC)疗效的临床因素。方法 从PubMed、EMBASE、Cochrane数据库中检索了mTNBC免疫治疗随机对照研究,并根据本研究设计纳排标准进行筛选。采用Review Manager 5.4软件进行Meta分析,比较不同转移状态乳腺癌免疫联合治疗的疗效。纳入研究采用Cochrane偏倚风险工具进行评估。研究终点为无进展生存期、总生存期。结果 Meta分析筛选了符合本研究目的2项随机对照试验。与单纯化疗组相比,免疫治疗联合化疗组改善了无肺转移、无肝转移及病灶累及范围局限的患者无进展生存期。部分无骨转移及累及广泛的患者可在免疫联合治疗中获益。结论 肿瘤累及范围相对局限的mTNBC患者使用阿替利珠单抗联合化疗的治疗疗效优于转移广泛的患者。Objective To investigate the clinical characteristics that affect the efficacy of atezolizumab combined with chemotherapy in metastatic triple-negative breast cancer(mTNBC).Methods Randomized controlled trials(RCT)related to mTNBC immunotherapy were searched from PubMed,EMBASE,and Cochrane Library.The literature obtained from the search was identified according to the inclusion and exclusion criteria.Then,a Meta-analysis was performed with Review Manager 5.4 software to compare the efficacy of combined immunotherapy for breast cancer with different states.The inclusion study was evaluated using the Cochrane bias risk tool.The endpoints of efficacy were progression-free survival(PFS)and overall survival(OS).Results Two RCTs were identified in the Meta-analysis.Compared with chemotherapy alone,immunotherapy combined with chemotherapy significantly improved the PFS of patients with no lung metastasis,no liver metastasis,and limited tumor invasion range.Partly patients with no bone metastasis or extensive involvement can benefit from immunotherapy combination therapy.Conclusions The therapeutic effect of atezolizumab combined with chemotherapy in mTNBC patients with relatively limited tumor involvement is superior to the patients with extensive metastases.

关 键 词：晚期三阴性乳腺癌 随机对照试验 META分析 免疫联合治疗 PD-1/PD-L1抑制剂 

分 类 号：R737.9[医药卫生—肿瘤]