■不同免疫抑制剂联合化疗治疗小细胞肺癌患者的疗效和安全性(广泛疾病小细胞肺癌,局限性疾病小细胞肺癌和复发性小细胞肺癌)仍然未知,并且没有直接比较其他免疫疗法的疗效和安全性的报告。
■本研究旨在比较一线免疫疗法联合化疗对小细胞肺癌患者的疗效和安全性。
■我们搜索了Pubmed,Embase,科克伦图书馆,CNKI,和万方数据库从开始到2020年11月11日发表的相关文章。纳入研究的偏倚风险是使用Cochrane偏倚风险(RoB)工具进行的。进行了多个贝叶斯网络荟萃分析。他们使用RStudio和STATA15.1版进行了数据分析。结果包括总生存期(OS),无进展生存期(PFS),响应稳定性(SOR),缓解持续时间(DOR)和3级或更高(AE等级≥3)的不良事件。为每个估计值提供95%置信区间(CI)。
■这项荟萃分析包括16项RCT研究,共5898例患者。对于操作系统,相对于化疗(MD=-4.49;95CI[-7.97,-1.03]),durvalumab+tremelimumab(MD=-4.62;95CI[-9.08,-0.11]),ipilimumab(MD=-4.26;95CI[-8.01,-0.3])和nivolumab(MD=-5.66;95CI[-10.44,-1.11])和nivolumab+ipilimumab(MD=-4.56;95CI[-8.7,-0.1]),serplulimab可以显着增加SCLC患者的OS。PFS之间无显著差异,SOR和DOR。AE的分析表明,就AE等级≥3的总体发生率而言,不同的免疫治疗联合化疗方案与单一化疗方案相似。然而,后对不同不良反应的常见症状进行累计排序,发现nivolumab在贫血发生概率中排名第一(99.08%),疲劳(84.78%),食欲下降(89.66%)。Durvalumab是最有可能的恶心(75.4%).Pembrolizumab(76.24%)最有可能引起瘙痒。化疗联合免疫治疗引起的腹泻比单独化疗少(80.16%)。
■根据我们的分析,serplulimab联合化疗对小细胞肺癌更有可能显示出更好的疗效,且安全性可控.然而,由于文献的数量,这种比较的证据显示出一些局限性。
■https://www.crd.约克。AC.英国/PROSPERO/,标识符CRD42023486053。
UNASSIGNED: The efficacy and safety of different immunosuppressants combined with chemotherapy in treating patients with small-cell lung cancer (extensive-disease small-cell lung cancer, limited-disease small-cell lung cancer and relapsed small-cell lung cancer) are still unknown, and there are no reports directly comparing the efficacy and safety of other immunotherapies.
UNASSIGNED: This study aimed to compare the efficacy and safety of first-line immunotherapy combined with chemotherapy in patients with small-cell lung cancer.
UNASSIGNED: We searched Pubmed, Embase, Cochrane Library, CNKI, and Wanfang databases for relevant articles published from inception to November 11, 2020. The risk of bias of the included studies was conducted using the Cochrane risk-of-bias (RoB) tool. Multiple Bayesian network meta-analyses were performed. They conducted data analysis using R Studio and STATA version 15.1. The outcomes comprised overall survival (OS), progression-free survival (PFS), stability of response (SOR), duration of response (DOR) and adverse events of grade 3 or higher (AE grade≥3). A 95% confidence interval (CI) was provided for each estimate.
UNASSIGNED: This meta-analysis included 16 RCT studies with 5898 patients. For OS, relative to chemotherapy (MD=-4.49; 95%CI [-7.97, -1.03]), durvalumab plus tremelimumab (MD=-4.62; 95%CI [-9.08, -0.11]), ipilimumab (MD=-4.26; 95%CI [-8.01, -0.3]) and nivolumab(MD=-5.66; 95%CI [-10.44, -1.11]) and nivolumab plus ipilimumab (MD=-4.56; 95%CI [-8.7, -0.1]), serplulimab can significantly increase the OS of SCLC patients. There was no significant difference between PFS, SOR and DOR. Analysis of AE showed that different immunotherapy combined chemotherapy regimens were similar to single chemotherapy regarding the overall incidence of AE grade≥3. However, after the cumulative ranking of the common symptoms of different adverse reactions, it was found that nivolumab ranked first in the occurrence probability of anemia (99.08%), fatigue (84.78%), and decreased appetite (89.66%). durvalumab was the most likely in nausea (75.4%). Pembrolizumab (76.24%) was most likely to cause pruritus. Chemotherapy combined with immunotherapy caused less diarrhea than chemotherapy alone (80.16%).
UNASSIGNED: According to our analysis, serplulimab combined with chemotherapy is more likely to show better efficacy with a manageable safety profile for small-cell lung cancer. However, the evidence for this comparison shows some limitations due to the number of literature.
UNASSIGNED: https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42023486053.