■系统评估安洛替尼靶向治疗晚期消化系统肿瘤(DSN)患者的疗效和安全性。
■临床试验摘自PubMed,Cochrane图书馆,WebofScience,Embase,截至2023年10月的中国国家知识基础设施(CNKI)和万方数据库。成果措施,包括治疗功效,生活质量(QOL)和不良事件,进行了提取和评估。
■二十次试验,包括1,613名晚期DSN患者,包括在内。结果表明,与单独的常规治疗相比,安洛替尼靶向治疗与常规治疗相结合可显着提高患者的6个月总生存期(OS,OR=1.76,CI=1.53至2.02,P<0.00001),总体反应(ORR,OR=1.76,CI=1.53至2.02,P<0.00001)和疾病控制率(DCR,OR=1.51,95%CI=1.25~1.84,P<0.0001)。此外,接受联合治疗的组高血压发生率更高(P<0.00001),蛋白尿(P<0.00001),疲劳(P<0.00001),腹泻(P<0.00001),高甘油三酯血症(P=0.02),丙氨酸氨基转移酶(ALT)增加(P=0.004),天冬氨酸转氨酶(AST)升高(P=0.006),厌食症(P<0.00001),体重减轻(P=0.002),腹痛(P=0.0006),甲状腺功能减退(P=0.02),QT间期延长(P=0.04)。其他不良事件分析,如胃肠道反应,白细胞减少症,和中性粒细胞减少症,差异不显著(P>0.05)。
■安洛替尼靶向治疗与常规治疗相结合,对DSNs治疗比单独使用常规治疗更有效。然而,这种联合治疗可能导致更高的高血压发病率,蛋白尿和手足综合征。因此,治疗前应考虑获益和风险。
UNASSIGNED: To systematically evaluate the efficacy and safety of anlotinib targeted therapy for the treatment of patients with advanced digestive system neoplasms (DSNs).
UNASSIGNED: Clinical trials were extracted from PubMed, the Cochrane Library, Web of Science, Embase, China National Knowledge Infrastructure (CNKI) and the Wanfang database up to October 2023. Outcome measures, including therapeutic efficacy, quality of life (QOL) and adverse events, were extracted and evaluated.
UNASSIGNED: Twenty trials, including 1,613 advanced DSNs patients, were included. The results indicated that, compared with conventional treatment alone, the combination of anlotinib targeted therapy with conventional treatment significantly improved the patients\' 6-months overall survival (OS, OR=1.76, CI=1.53 to 2.02, P<0.00001), overall response (ORR, OR=1.76, CI=1.53 to 2.02, P<0.00001) and disease control rate (DCR, OR=1.51, 95% CI=1.25 to 1.84, P<0.0001). Moreover, the group that received the combined therapy had higher rates of hypertension (P<0.00001), proteinuria (P<0.00001), fatigue (P<0.00001), diarrhea (P<0.00001), hypertriglyceridemia (P=0.02), alanine aminotransfease (ALT)increased (P=0.004), aspartate transaminase (AST) increased (P=0.006), anorexia (P<0.00001), weight loss (P=0.002), abdominal pain (P=0.0006), hypothyroidism (P=0.02), prolonged QT interval (P=0.04). Analyses of other adverse events, such as gastrointestinal reaction, leukopenia, and neutropenia, did not reveal significant differences (P>0.05).
UNASSIGNED: The combination of anlotinib targeted therapy and conventional treatment is more effective for DSNs treatment than conventional treatment alone. However, this combined treatment could lead to greater rates of hypertension, albuminuria and hand-foot syndrome. Therefore, the benefits and risks should be considered before treatment.