Systematic review and meta-analysis of temozolomide in animal models of glioma: was clinical efficacy predicted?
Systematic review and meta-analysis of temozolomide in animal models of glioma: was clinical efficacy predicted?
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DOI：
10.1038/bjc.2012.504
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发表时间：
2013-01-15
影响因子：
8.8
通讯作者：
Whittle, I. R.
中科院分区：
文献类型：
--
作者：
Hirst, T. C.;Vesterinen, H. M.;Sena, E. S.;Egan, K. J.;Macleod, M. R.;Whittle, I. R.
恶性胶质瘤是一种侵袭性肿瘤，尽管手术和放化疗是最佳选择，但其预后通常很差。自2005年以来，替莫唑胺已被确定为一线化疗。我们研究了体内胶质瘤模型在预测临床疗效中的作用。我们搜索了三个在线数据库，以系统地确定在胶质瘤动物模型中测试替莫唑胺的出版物。提取中位存活率和处理动物的数量，并使用12分量表评估质量；随机效应荟萃分析用于评估疗效。我们分析了研究设计和质量的影响，并寻找发表偏见的证据。我们确定了60篇使用替莫唑胺治疗脑胶质瘤模型的文献，涉及2443只动物。替莫唑胺与未经治疗的对照组相比，生存期延长1.88倍(95%可信区间1.74~2.03)，肿瘤体积缩小50.4%(41.8~58.9)。研究设计特点在研究间异质性中占很大比例，而且有证据表明存在显著的发表偏倚。这些数据反映了临床试验中的数据，即替莫唑胺提高了存活率并减少了肿瘤体积，即使在考虑到发表偏见后也是如此。替莫唑胺的实验性体内胶质瘤研究与其他胶质瘤疗法的不同之处在于其一致的疗效和成功地转化为临床药物。
Malignant glioma is an aggressive tumour commonly associated with a dismal outcome despite optimal surgical and radio-chemotherapy. Since 2005 temozolomide has been established as first-line chemotherapy. We investigate the role of in vivo glioma models in predicting clinical efficacy. We searched three online databases to systematically identify publications testing temozolomide in animal models of glioma. Median survival and number of animals treated were extracted and quality was assessed using a 12-point scale; random effects meta-analysis was used to estimate efficacy. We analysed the impact of study design and quality and looked for evidence of publication bias. We identified 60 publications using temozolomide in models of glioma, comprising 2443 animals. Temozolomide prolonged survival by a factor of 1.88 (95% CI 1.74–2.03) and reduced tumour volume by 50.4% (41.8–58.9) compared with untreated controls. Study design characteristics accounted for a significant proportion of between-study heterogeneity, and there was evidence of a significant publication bias. These data reflect those from clinical trials in that temozolomide improves survival and reduces tumour volume, even after accounting for publication bias. Experimental in vivo glioma studies of temozolomide differ from those of other glioma therapies in their consistent efficacy and successful translation into clinical medicine.
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影响因子：
2.5
作者：
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通讯作者：
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