Efficacy and safety of immune checkpoint inhibitors in gastric cancer: a network meta-analysis of well-designed randomized controlled trials.
Efficacy and safety of immune checkpoint inhibitors in gastric cancer: a network meta-analysis of well-designed randomized controlled trials.
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免疫检查点抑制剂在胃癌中的疗效和安全性：精心设计的随机对照试验的网络荟萃分析
DOI：
10.21037/atm-20-6639
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发表时间：
2021-03
影响因子：
--
通讯作者：
Zhu Z
中科院分区：
文献类型：
--
作者：
Pan S;Li K;Huang B;Huang J;Xu H;Zhu Z
背景免疫检查点抑制剂（ICI）抑制程序性死亡1（PD-1）/程序性死亡配体1（PD-L1）和细胞毒性T淋巴细胞抗原4（CTLA-4）的相互作用，作为晚期胃癌（AGC）的治疗选择显示出良好的前景。本文分析了设计良好的临床试验，以评估免疫治疗AGC的有效性和安全性。方法检索PubMed、Embase、科克伦图书馆和Medline中2020年4月之前发表的AGC治疗随机对照试验（RCT）。评价无进展生存期（PFS）、总生存期（OS）、客观缓解率（ORR）和治疗相关不良事件（TRAE），以确定ICI的疗效和安全性。在贝叶斯框架下使用随机效应模型进行网络荟萃分析。使用累积排序（SUCRA）曲线下的表面对每个处理的能力进行排序。我们的分析包括5项研究，7种免疫治疗方案和1，730例患者。网络荟萃分析显示，nivolumab 1 mg/kg每3周一次+ipilimumab 3 mg/kg每3周一次（88.369%）是最有可能改善PFS的方案。纳武单抗3 mg/kg每3周一次（84.563%）和纳武单抗1 mg/kg每3周一次加伊匹单抗3 mg/kg每3周一次（84.556%）对于OS结局同样最佳，耐受性极佳。avelumab 10 mg/kg每2周一次方案（91.167%）的TRAE最低。所有免疫疗法的反应率相似。结论我们推荐nivolumab 3 mg/kg每2周一次或nivolumab 1 mg/kg每3周一次+ipilimumab 3 mg/kg每3周一次作为首选方案，因为它们具有较高的疗效。
Background Immune checkpoint inhibitors (ICIs) that inhibit the programmed death 1 (PD-1)/programmed death-ligand 1 (PD-L1) and cytotoxic T-lymphocyte antigen 4 (CTLA-4) interactions have shown promising prospects as treatment options for advanced gastric cancer (AGC). This manuscript analyzed well designed clinical trials to evaluate the efficacy and safety of immunotherapy in AGC. Methods PubMed, Embase, the Cochrane Library, and Medline were searched for randomized controlled trials (RCTs) of AGC treatments that were published before April 2020. Progression-free survival (PFS), overall survival (OS), objective response rate (ORR), and treatment-related adverse events (TRAEs) were evaluated to determine the efficacy and safety of ICIs. Network meta-analysis was performed using a random-effects model under the Bayesian framework. The ability of each treatment was ranked using the surface under the cumulative ranking (SUCRA) curve. Results Our analysis included five studies having seven immunotherapy regimens and 1,730 patients. The network meta-analysis showed that nivolumab 1 mg/kg every 3 weeks plus ipilimumab 3 mg/kg every 3 weeks (88.369%) was the regimen most likely to improve PFS. Nivolumab 3 mg/kg every 3 weeks (84.563%) and nivolumab 1 mg/kg every 3 weeks plus ipilimumab 3 mg/kg every 3 weeks (84.556%) were similarly best for OS outcome with excellent tolerance. The regimen of avelumab 10 mg/kg every 2 weeks (91.167%) had the lowest TRAEs. All immunotherapies had similar response rates. Conclusions We recommend nivolumab 3 mg/kg every 2 weeks or nivolumab 1 mg/kg every 3 weeks plus ipilimumab 3 mg/kg every 3 weeks as the preferred regimen due to their high efficacies.
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影响因子：
11.5
作者：
Ralph, Christy;Elkord, Eyad;Thistlethwaite, Fiona C.
通讯作者：
Thistlethwaite, Fiona C.
影响因子：
16.2
作者：
Feng, Rui-Mei;Zong, Yi-Nan;Xu, Rui-Hua
通讯作者：
Xu, Rui-Hua
影响因子：
11.5
作者：
Kubota, Yohei;Kawazoe, Akihito;Shitara, Kohei
通讯作者：
Shitara, Kohei
DOI：
10.1016/s0140-6736(17)33326-3
发表时间：
2018-03-17
期刊：
Lancet (London, England)
影响因子：
--
作者：
Allemani C;Matsuda T;Di Carlo V;Harewood R;Matz M;Nikšić M;Bonaventure A;Valkov M;Johnson CJ;Estève J;Ogunbiyi OJ;Azevedo E Silva G;Chen WQ;Eser S;Engholm G;Stiller CA;Monnereau A;Woods RR;Visser O;Lim GH;Aitken J;Weir HK;Coleman MP;CONCORD Working Group
通讯作者：
CONCORD Working Group
影响因子：
168.9
作者：
Shitara, Kohei;Ozguroglu, Mustafa;Fuchs, Charles S.
通讯作者：
Fuchs, Charles S.