PD-1/PD-L1抑制剂不同联合方案治疗晚期卵巢癌的疗效和不良反应的meta分析  

Meta-analysis of efficacy and adverse effects of different combination schemes of PD-1/PD-L1 inhibitors in the treatment of ovarian cancer

作　　者：张倩[1] 徐志宏[1] ZHANG Qian;XU Zhihong(Department of Oncology,Fourth Hospital of Hebei Medical University,Shijiazhuang 050000,China)

机构地区：[1]河北医科大学第四医院肿瘤内科,石家庄050000

出　　处：《中国妇产科临床杂志》2024年第4期292-297,共6页Chinese Journal of Clinical Obstetrics and Gynecology

摘　　要：目的探究程序性细胞死亡蛋白1(PD-1)/程序性细胞死亡蛋白1配体(PD-L1)抑制剂不同联合方案用于晚期卵巢癌后线治疗的疗效和不良反应。方法通过检索Pubmed、Embase和Cochrane library文献库,收集截至2023年11月关于PD-1/PD-L1免疫抑制剂联合不同策略治疗卵巢癌的文献,对其进行质量评估和数据提取,采用Revman 5.3及Stata 15.0软件进行荟萃分析。结果最终纳入11项单臂研究。荟萃分析结果显示,PD-1/PD-L1抑制剂联合不同方案【化疗药物、聚腺苷二磷酸核糖聚合酶(PARP)抑制剂和抗血管靶向药物】治疗晚期卵巢癌在临床上获益,客观缓解率为24%。因异质性为60%,对其原因进行亚组分析,结果显示,PD-1/PD-L1抑制剂联合抗血管靶向药物在治疗晚期卵巢癌的客观缓解率为25%,疾病控制率为60%;联合抗血管靶向药物的客观缓解率为64%;PD-1/PD-L1抑制剂联合不同药物治疗6个月的无进展生存率为43%,12个月的无进展生存率为26%,12个月的总生存率为79%。3~5级不良反应的发生率为28%,以高血压、恶心、贫血最为多见。结论PD-1/PD-L1抑制剂联合不同方案治疗晚期卵巢癌明显改善患者的生存和预后,且不良反应多可耐受。Objective To investigate the efficacy and side effects of different combined strategies of programmed cell death protein 1(PD-1)/programmed cell death protein 1 ligand(PD-L1)inhibitors in the treatment of advanced ovarian cancer.Methods By searching Pubmed,Embase and Cochrane library,literature on PD-1/PD-L1 immunosuppressants combined with different strategies for ovarian cancer up to November 2023 was collected for quality assessment and data extraction.The meta-analysis was performed using Revman 5.3 and Stata 15.0 software.Results Eleven single-arm studies were included.The results of meta-analysis showed that PD-1/PD-L1 inhibitors combined with different regimens[chemotherapy agents,polyadenosine diphosphoribose polymerase(PARP)inhibitors,and anti-vascular targeting agents]in the treatment of advanced ovarian cancer were clinically beneficial,with an objective response rate of 24%.The heterogeneity was 60%,and the causes were analyzed by subgroups.The results showed that the objective remission rate of PD-1/PD-L1 inhibitor combined with anti-vascular targeted drugs in the treatment of advanced ovarian cancer was 25%,and the disease control rate was 60%.The objective response rate of combined anti-vascular targeting drugs was 64%.Treatment with PD-1/PD-L1 inhibitors combined with different drugs had a progression-free survival rate of 43%at 6 months,26%at 12 months,and 79%overall at 12 months.The incidence of grade 3~5 adverse reactions was 28%,with hypertension,nausea and anemia being the most common.Conclusions PD-1/PD-L1 inhibitors combined with different regiments in the treatment of advanced ovarian cancer significantly improved the survival and prognosis of patients.And the incidence of adverse reactions is considerable.

关 键 词：卵巢癌 贝伐珠单抗 聚腺苷二磷酸核糖聚合酶抑制剂 免疫检查点抑制剂 疗效 安全性 META分析 

分 类 号：R737.31[医药卫生—肿瘤]