背景:本系统综述和荟萃分析旨在评估Bruton酪氨酸激酶抑制剂(BTKis)治疗中枢神经系统淋巴瘤(CNSL)的疗效和安全性。
方法:进行了系统评价,以确定PubMed的相关研究,Embase,科克伦图书馆,WebofScience,万方,CNKI,和CBM数据库。研究包括接受BTKis并报告总体反应(OR)的CNSL患者,完全缓解(CR),和部分反应(PR)。使用STATA15.0进行总体效果分析。利用随机效应模型计算合并率,并确定所有结局的95%置信区间(CI).
结果:共有21项研究纳入meta分析,涉及368例患者。对于新诊断的CNSL,由于体积小简单,我们进行了定量描述,ORR可以达到100%。对于复发/难治性患者,合并的ORR为72%(95%CI:64-80%,I2=54.89%,p=0.00),合并的CR和PR为43%(95%CI:33-54%,I2=65.40%,p=0.00)和23%(95%CI:13-35%,I2=78.05%,p=0.00),分别。大多数不良事件与血液学相关,通常是可控的。
结论:BTKis在治疗CNSL患者中显示出可接受的疗效和安全性。然而,仍需要大型且精心设计的试验来确认BTKis是CNSL的治疗方法.
BACKGROUND: This systematic review and meta-analysis aimed to evaluate the efficacy and safety of Bruton tyrosine kinase inhibitors (BTKis) for central nervous system lymphoma (CNSL).
METHODS: A systematic review was carried out to identify relevant studies from the PubMed, Embase, Cochrane Library, Web of Science, WanFang, CNKI, and CBM databases. The studies included patients with CNSL who received BTKis and reported the overall response (OR), complete remission (CR), and partial response (PR). An overall effect analysis was performed using STATA 15.0. A random-effects model was utilized to calculate the pooled rates, and 95% confidence intervals (CI) were determined for all outcomes.
RESULTS: A total of 21 studies involving 368 patients were included in the meta-analysis. For newly diagnosed CNSL, due to the small simple size, we conducted a quantitative description, and the ORR could reach up to 100%. For relapsed/refractory patients, the pooled ORR was 72% (95% CI: 64-80%, I2 = 54.89%, p = 0.00), with a pooled CR and PR of 43% (95% CI: 33-54%, I2 = 65.40%, p = 0.00) and 23% (95% CI: 13-35%, I2 = 78.05%, p = 0.00), respectively. Most adverse events were hematology-related and generally manageable.
CONCLUSIONS: BTKis showed acceptable efficacy and safety in treating patients with CNSL. However, large and well-designed trials are still required to confirm BTKis as a treatment for CNSL.