Abstract：
Several successful attempts have been recorded with PD-L1 blockade via atezolizumab monotherapy or combination therapy with chemotherapy in patients with metastatic triple-negative breast cancer (mTNBC). Due to the lack of a large-scale study, we present a meta-analysis aimed at evaluating the safety and efficacy of this promising strategy in patients with mTNBC.
A comprehensive literature search was conducted using electronic databases to identify eligible RCTs. Twelve studies, including 2479 mTBNC patients treated with atezolizumab monotherapy or in combination with chemotherapy, were included up to January 2022. The PRISMA checklist protocol and the I2 statistic were applied for quality assessment and heterogeneity tests of the selected trials, respectively. Fixed and random-effects models were estimated based on the heterogeneity tests, and statistical analysis was performed using CMA.
Our pooled findings demonstrated that the median overall survival (OS) and progression-free survival (PFS) were 16.526 and 5.814 months in mTNBC patients, respectively. Furthermore, when comparing efficacy indicators between PD-L1-positive and PD-L1-negative groups, mTNBC patients with PD-L1 had better OS, PFS, and ORR than PD-L1-negative patients. Also, the immune-related adverse event incident for alopecia was higher (51.9%) than other complications across atezolizumab therapy.
Moreover, the pooled analysis indicated that the overall rate of lung metastasis following atezolizumab therapy was 42.8%, which was higher than the rates of metastasis in bone (26.9%), brain (5.4%), and lymph node (6.5%). Atezolizumab showed a manageable safety profile and had promising and durable anti-tumor efficacy in TMBC patients. Higher PD-L1 expression may be closely correlated with better clinical efficacy.
A comprehensive literature search was conducted using electronic databases to identify eligible RCTs. Twelve studies, including 2479 mTBNC patients treated with atezolizumab monotherapy or in combination with chemotherapy, were included up to January 2022. The PRISMA checklist protocol and the I2 statistic were applied for quality assessment and heterogeneity tests of the selected trials, respectively. Fixed and random-effects models were estimated based on the heterogeneity tests, and statistical analysis was performed using CMA.
Our pooled findings demonstrated that the median overall survival (OS) and progression-free survival (PFS) were 16.526 and 5.814 months in mTNBC patients, respectively. Furthermore, when comparing efficacy indicators between PD-L1-positive and PD-L1-negative groups, mTNBC patients with PD-L1 had better OS, PFS, and ORR than PD-L1-negative patients. Also, the immune-related adverse event incident for alopecia was higher (51.9%) than other complications across atezolizumab therapy.
Moreover, the pooled analysis indicated that the overall rate of lung metastasis following atezolizumab therapy was 42.8%, which was higher than the rates of metastasis in bone (26.9%), brain (5.4%), and lymph node (6.5%). Atezolizumab showed a manageable safety profile and had promising and durable anti-tumor efficacy in TMBC patients. Higher PD-L1 expression may be closely correlated with better clinical efficacy.
摘要：
背景：在转移性三阴性乳腺癌（mTNBC）患者中，通过阿特珠单抗单药治疗或联合化疗治疗PD-L1阻断已成功尝试。由于缺乏大规模的研究，我们提出了一项荟萃分析,旨在评估这种有前景的治疗策略在mTNBC患者中的安全性和有效性.
方法：使用电子数据库进行全面的文献检索，以确定合格的随机对照试验。12项研究,包括2479例接受阿特珠单抗单药或联合化疗治疗的mTBNC患者，包括到2022年1月。PRISMA检查表方案和I2统计量用于所选试验的质量评估和异质性测试。分别。固定效应和随机效应模型是基于异质性测试估计的，并使用CMA进行统计分析。
结果：我们的汇总研究结果表明，mTNBC患者的中位总生存期（OS）和无进展生存期（PFS）分别为16.526和5.814个月，分别。此外，当比较PD-L1阳性和PD-L1阴性组的疗效指标时，mTNBC患者PD-L1有较好的OS，PFS,和ORR比PD-L1阴性患者。此外，脱发的免疫相关不良事件发生率(51.9%)高于阿特珠单抗治疗期间的其他并发症.
结论：此外，汇总分析显示阿特珠单抗治疗后肺转移率为42.8%,高于骨转移率（26.9%），大脑(5.4%)，淋巴结（6.5%）。Atezolizumab在TMBC患者中显示出可控的安全性，并具有有希望和持久的抗肿瘤功效。较高的PD-L1表达可能与较好的临床疗效密切相关。
方法：使用电子数据库进行全面的文献检索，以确定合格的随机对照试验。12项研究,包括2479例接受阿特珠单抗单药或联合化疗治疗的mTBNC患者，包括到2022年1月。PRISMA检查表方案和I2统计量用于所选试验的质量评估和异质性测试。分别。固定效应和随机效应模型是基于异质性测试估计的，并使用CMA进行统计分析。
结果：我们的汇总研究结果表明，mTNBC患者的中位总生存期（OS）和无进展生存期（PFS）分别为16.526和5.814个月，分别。此外，当比较PD-L1阳性和PD-L1阴性组的疗效指标时，mTNBC患者PD-L1有较好的OS，PFS,和ORR比PD-L1阴性患者。此外，脱发的免疫相关不良事件发生率(51.9%)高于阿特珠单抗治疗期间的其他并发症.
结论：此外，汇总分析显示阿特珠单抗治疗后肺转移率为42.8%,高于骨转移率（26.9%），大脑(5.4%)，淋巴结（6.5%）。Atezolizumab在TMBC患者中显示出可控的安全性，并具有有希望和持久的抗肿瘤功效。较高的PD-L1表达可能与较好的临床疗效密切相关。
