PD-1 inhibitors plus oxaliplatin or cisplatin-based chemotherapy in first-line treatments for advanced gastric cancer: A network meta-analysis.
PD-1 inhibitors plus oxaliplatin or cisplatin-based chemotherapy in first-line treatments for advanced gastric cancer: A network meta-analysis.
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DOI：
10.3389/fimmu.2022.905651
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发表时间：
2022
影响因子：
7.3
通讯作者：
Qu, Xiujuan
中科院分区：
文献类型：
--
作者：
Guo, Xiaoyu;Yang, Bowen;He, Lingzi;Sun, Yiting;Song, Yujia;Qu, Xiujuan
目前，程序性细胞死亡蛋白1（PD-1）抑制剂联合不同化疗方案在晚期胃癌（AGC）一线治疗中的作用尚未进行直接比较。本研究进行了网络荟萃分析（NMA），以评价PD-1抑制剂联合奥沙利铂或顺铂化疗的疗效和安全性。使用PubMed、Embase和科克伦中心注册数据库，寻找一系列研究一线PD-1抑制剂联合化疗的III期随机对照试验（RCT），以及比较一线奥沙利铂和含顺铂化疗治疗AGC以进行NMA的III期RCT。主要结局是总生存期（OS），其他结局包括无进展生存期（PFS）、客观缓解率（ORR）和治疗相关不良事件（TRAE）。纳入了8项符合条件的RCT，涉及5723例患者。与PD-1抑制剂联合顺铂化疗相比，PD-1抑制剂联合奥沙利铂化疗可延长OS，但无统计学意义（风险比[HR]：0.82，95%可信区间[CI]：0.63-1.06）。然而，对于联合阳性评分（CPS）≥ 1的患者，PD-1抑制剂联合奥沙利铂化疗显著延长了OS（HR：0.75，95% CI：0.57-0.99）。PD-1抑制剂联合奥沙利铂化疗的PFS显著长于PD-1抑制剂联合顺铂化疗（HR：0.72，95% CI：0.53-0.99）。关于安全性，PD-1抑制剂+奥沙利铂化疗与PD-1抑制剂+顺铂化疗之间≥ 3例TRAE的发生率相似（RR：0. 86，95% CI：0. 66 - 1. 12）。累积排序面积曲线下面积（SUCRA）显示PD-1抑制剂联合奥沙利铂化疗的OS（97.7%）、PFS（99.3%）和ORR（89.0%）排名第一。对于基于奥沙利铂的方案，nivolumab+基于奥沙利铂的化疗与sintiliumab+基于奥沙利铂的化疗在OS、PFS、ORR和≥3个TRAE方面无显著差异。与PD-1抑制剂联合顺铂为基础的化疗相比，PD-1抑制剂联合奥沙利铂为基础的化疗显著延长PFS。从疗效和安全性两方面考虑，PD-1抑制剂联合奥沙利铂化疗可能是AGC一线治疗的较好选择。
Currently, there has been no direct comparison between programmed cell death protein 1 (PD-1) inhibitors plus different chemotherapy regimens in first-line treatments for advanced gastric cancer (AGC). This study performed a network meta-analysis (NMA) to evaluate the efficacy and safety of PD-1 inhibitors plus oxaliplatin- or cisplatin-based chemotherapy. PubMed, Embase, and the Cochrane Central Register were used to seek a series of phase III randomized controlled trials (RCTs) studying on first-line PD-1 inhibitors plus chemotherapy and phase III RCTs comparing first-line oxaliplatin and cisplatin-based chemotherapy for AGC to perform NMA. The main outcome was overall survival (OS) and other outcomes included progression-free survival (PFS), objective response rate (ORR), and treatment-related adverse events (TRAEs). Eight eligible RCTs involving 5723 patients were included. Compared with PD-1 inhibitors plus cisplatin-based chemotherapy, PD-1 inhibitors plus oxaliplatin-based chemotherapy could prolong the OS without statistical significance (hazard ratio [HR]: 0.82, 95% credible interval [CI]: 0.63-1.06). However, for patients with combined positive score (CPS) ≥ 1, PD-1 inhibitors plus oxaliplatin-based chemotherapy significantly prolonged the OS (HR: 0.75, 95% CI: 0.57-0.99). PFS in PD-1 inhibitors plus oxaliplatin-based chemotherapy was significantly longer than that in PD-1 inhibitors plus cisplatin-based chemotherapy (HR: 0.72, 95% CI: 0.53-0.99). Regarding safety, the incidence of ≥ 3 TRAEs was similar between PD-1 inhibitors plus oxaliplatin-based chemotherapy and PD-1 inhibitors plus cisplatin-based chemotherapy (RR: 0.86, 95% CI: 0.66-1.12). The surface under the cumulative ranking area curve (SUCRA) indicated that PD-1 inhibitors plus oxaliplatin-based chemotherapy ranked first for OS (97.7%), PFS (99.3%), and ORR (89.0%). For oxaliplatin-based regimens, there was no significant difference between nivolumab plus oxaliplatin-based chemotherapy and sintilimab plus oxaliplatin-based chemotherapy in terms of OS, PFS, ORR, and ≥3 TRAEs. Compared with PD-1 inhibitors plus cisplatin-based chemotherapy, PD-1 inhibitors plus oxaliplatin-based chemotherapy significantly prolonged PFS. Considering both efficacy and safety, PD-1 inhibitors plus oxaliplatin-based chemotherapy might be a better option in the first-line treatment for AGC.
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DOI：
10.1007/s10120-018-0809-y
发表时间：
2018-09
期刊：
Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association
影响因子：
--
作者：
Lu Z;Zhang X;Liu W;Liu T;Hu B;Li W;Fan Q;Xu J;Xu N;Bai Y;Pan Y;Xu Q;Bai W;Xia L;Gao Y;Wang W;Shu Y;Shen L
通讯作者：
Shen L
影响因子：
28.2
作者：
Chen PL;Roh W;Reuben A;Cooper ZA;Spencer CN;Prieto PA;Miller JP;Bassett RL;Gopalakrishnan V;Wani K;De Macedo MP;Austin-Breneman JL;Jiang H;Chang Q;Reddy SM;Chen WS;Tetzlaff MT;Broaddus RJ;Davies MA;Gershenwald JE;Haydu L;Lazar AJ;Patel SP;Hwu P;Hwu WJ;Diab A;Glitza IC;Woodman SE;Vence LM;Wistuba II;Amaria RN;Kwong LN;Prieto V;Davis RE;Ma W;Overwijk WW;Sharpe AH;Hu J;Futreal PA;Blando J;Sharma P;Allison JP;Chin L;Wargo JA
通讯作者：
Wargo JA
影响因子：
7.4
作者：
Lee, Keun-Wook;Chung, Ik-Joo;Kang, Yoon-Koo
通讯作者：
Kang, Yoon-Koo
影响因子：
39.2
作者：
Hutton, Brian;Salanti, Georgia;Moher, David
通讯作者：
Moher, David
影响因子：
51.1
作者：
Kang, Yoon-Koo;Chin, Keisho;Boku, Narikazu
通讯作者：
Boku, Narikazu