Comparative efficacy and tolerability of novel agents vs chemotherapy in relapsed and refractory T-cell lymphomas: a meta-analysis.
Comparative efficacy and tolerability of novel agents vs chemotherapy in relapsed and refractory T-cell lymphomas: a meta-analysis.
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DOI：
10.1182/bloodadvances.2022007425
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发表时间：
2022-08-23
期刊：
影响因子：
7.5
通讯作者：
Jain, Salvia
中科院分区：
文献类型：
--
作者：
Shafagati, Nazila;Koh, Min J.;Boussi, Leora;Park, Hyun J.;Stuver, Robert;Bain, Paul;Foss, Francine M.;Shen, Changyu;Jain, Salvia
当代SA在治疗R/R PTCL患者时显示出与传统化疗相当的疗效。表观遗传和信号调节剂与化疗在R/R ptcl -非其他特异性和血管免疫母细胞TCL中的作用相当。（复发和难治性[R/R]）外周t细胞淋巴瘤（PTCL）的最佳治疗策略尚未明确，随着几种新型单药（SA）的批准，联合化疗（CC）与单药策略的比较疗效仍不清楚。我们进行了一项荟萃分析，以评估SA对CC的总缓解率（ORR）和毒性。MEDLINE、Embase、Web of Science Core Collection和Cochrane系统地检索了研究明确SA或蒽环类、异环磷酰胺类、吉西他滨类和铂类治疗方案的I、II和III期试验。纳入了151篇文章，包括60项涉及1075名患者的I期试验、95项涉及3246名患者的II期试验和23项涉及1888名患者的III期试验。试验中存在高度的异质性。使用随机效应模型，在I期试验中SA的估计ORR为40%(95%置信区间[CI]， 34.7%, 46.9%)，相对于CC的41% (95% CI, 27.4%, 56.1%, P = 0.97)，在II期试验中SA的估计ORR为34.4% (95% CI, 30.4%, 38.7%)，相对于CC的估计ORR为55.3% （95% CI, 31%, 77.2%, P = 0.1）。PTCL组织学亚型和药物类别之间的ORR有显著的亚组差异。我们的研究结果强调SA作为R/R PTCL的一个有吸引力的门诊选择，并且将其纳入前期治疗范例的发展中值得迫切考虑。我们的研究结果强调了纳入SA临床试验是治疗R/R PTCL的关键策略。
Contemporary SA demonstrated comparable responses to conventional chemotherapy for treatment of patients with R/R PTCL. Epigenetic and signaling modulators are comparable to chemotherapy in R/R PTCL–not otherwise specified and angioimmunoblastic TCL. Optimal treatment strategies for (relapsed and refractory [R/R]) peripheral T-cell lymphoma (PTCL) have not been well defined, and with the approval of several novel single agents (SA), the comparative efficacy of combination chemotherapy (CC) to single-agent strategies remains unclear. We conducted a meta-analysis to evaluate overall response rates (ORR) and toxicities of SA to CC. MEDLINE, Embase, Web of Science Core Collection, and Cochrane were systematically searched for phase I, phase II, and phase III trials investigating a defined SA or an anthracycline-, ifosfamide-, gemcitabine-, and platinum-based regimens. One hundred and fifty-one articles were included, encompassing single and combinations of 60 phase I trials involving 1075 patients, 95 phase II trials involving 3246, and 23 phase III trials involving 1888 patients. There was a high degree of heterogeneity in the trials. Using a random-effects model, the estimated ORR for SA in phase I trials were 40% (95% confidence interval [CI], 34.7%, 46.9%) relative to 41% for CC (95% CI, 27.4%, 56.1%; P = .97) and in phase II trials 34.4% (95% CI, 30.4%, 38.7%) for SA vs 55.3% (95% CI, 31%, 77.2%; P = .1) for CC. There were significant subgroup differences in ORR between histological subtypes of PTCL and drug classes. Our results highlight SA as an attractive outpatient option for R/R PTCL, and their incorporation in the development of upfront treatment paradigms merits urgent consideration. Our results underscore enrollment in clinical trials of SA as a critical strategy for R/R PTCL.
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影响因子：
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作者：
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通讯作者：
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