Efficacy and safety of immunological checkpoint inhibitors combined with anti-angiogenic drugs in first-line treatment of metastatic renal cell carcinoma: a systematic review and meta-analysis.
Efficacy and safety of immunological checkpoint inhibitors combined with anti-angiogenic drugs in first-line treatment of metastatic renal cell carcinoma: a systematic review and meta-analysis.
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DOI：
10.21037/tau-20-969
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发表时间：
2021-01
影响因子：
2
通讯作者：
Xie W
中科院分区：
文献类型：
--
作者：
Xie Y;Chen Z;Zhong Q;Chen Y;Shangguan W;Xie W
免疫检查点抑制剂（ICI）已显示出用于转移性肾细胞癌（mRCC）二线治疗的有希望的结果。到目前为止，几项随机对照试验也评价了ICI一线治疗mRCC的疗效。在本研究中，我们对相关研究进行了荟萃分析，以进一步阐明ICI联合抗血管生成药物治疗mRCC的有效性和安全性。我们检索了PubMed、Embase和科克伦数据库中2019年11月20日之前发表的ICI联合抗血管生成药物一线治疗mRCC的RCT试验。根据科克伦协作网的方法学建议进行荟萃分析。4篇文章（共2，967例患者）符合纳入标准。我们的荟萃分析显示，试验组的无进展生存期（PFS）和客观缓解率（ORR）显著提高，而总生存期（OS）无显著差异（HR 0.75，95% CI：0.67-0.84; HR 1.43，95% CI：1.07-1.91; HR 0.74，95% CI：0.53-1.03）。PD-L1表达分层后，实验组PD-L1阳性患者的OS、PFS和ORR显著增加（HR 0.74，95% CI：0.56-0.96; HR 1.66，95% CI：1.11-2.49; HR 0.65，95% CI：0.57-0.75）。免疫检查点抑制剂联合抗血管生成药物作为mRCC的一线治疗可改善PFS和ORR。这种效应在PD-L1阳性患者中更为明显，其中ICI也改善了OS。ICI不会增加不良事件的发生率。
Immune checkpoint inhibitors (ICIs) have shown promising results for the second-line treatment of metastatic renal cell carcinoma (mRCC). Several randomized controlled trials have so far also evaluated the efficacy of ICIs for first-line treatment of mRCC. In this study, we conducted a meta-analysis of relevant studies to further clarify the efficacy and safety of ICIs combined with anti-angiogenic drugs for the treatment of mRCC. We searched the PubMed, Embase, and Cochrane libraries for RCT trials of ICIs combined with anti-angiogenic drugs for first-line treatment of mRCC published before November 20, 2019. A meta-analysis was conducted based on methodological recommendations by the Cochrane Collaboration. Four articles with a total of 2,967 patients met the inclusion criteria. Our meta-analysis revealed that progression-free survival (PFS) and objective response rate (ORR) were significantly improved in the experimental group while there was no significant difference in overall survival (OS) (HR 0.75, 95% CI: 0.67–0.84; HR 1.43, 95% CI: 1.07–1.91; HR 0.74, 95% CI: 0.53–1.03). After stratification for PD-L1 expression, OS, PFS, and ORR of PD-L1 positive patients were significantly increased in the experimental group (HR 0.74, 95% CI: 0.56–0.96; HR 1.66, 95% CI: 1.11–2.49; HR 0.65, 95% CI: 0.57–0.75). Immunological checkpoint inhibitors combined with anti-angiogenic drugs as a first-line treatment for mRCC improve PFS and ORR. This effect is more pronounced in PD-L1 positive patients, where ICIs also improve OS. ICIs do not increase the incidence of adverse events.
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影响因子：
10.1
作者：
Hodi FS;Lawrence D;Lezcano C;Wu X;Zhou J;Sasada T;Zeng W;Giobbie-Hurder A;Atkins MB;Ibrahim N;Friedlander P;Flaherty KT;Murphy GF;Rodig S;Velazquez EF;Mihm MC Jr;Russell S;DiPiro PJ;Yap JT;Ramaiya N;Van den Abbeele AD;Gargano M;McDermott D
通讯作者：
McDermott D
影响因子：
168.9
作者：
Rini, Brian I.;Powles, Thomas;Motzer, Robert J.
通讯作者：
Motzer, Robert J.
影响因子：
3.2
作者：
Iacovelli, Roberto;Sternberg, Cora N.;Procopio, Giuseppe
通讯作者：
Procopio, Giuseppe
DOI：
10.1056/nejmoa1510665
发表时间：
2015-11-05
期刊：
The New England journal of medicine
影响因子：
--
作者：
Motzer RJ;Escudier B;McDermott DF;George S;Hammers HJ;Srinivas S;Tykodi SS;Sosman JA;Procopio G;Plimack ER;Castellano D;Choueiri TK;Gurney H;Donskov F;Bono P;Wagstaff J;Gauler TC;Ueda T;Tomita Y;Schutz FA;Kollmannsberger C;Larkin J;Ravaud A;Simon JS;Xu LA;Waxman IM;Sharma P;CheckMate 025 Investigators
通讯作者：
CheckMate 025 Investigators
影响因子：
51.1
作者：
Choueiri, Toni K.;Larkin, James;Rini, Brian I.
通讯作者：
Rini, Brian I.