Efficacy and safety of anti-PD-1/anti-PD-L1 antibody therapy in treatment of advanced gastric cancer or gastroesophageal junction cancer: A meta-analysis.
Efficacy and safety of anti-PD-1/anti-PD-L1 antibody therapy in treatment of advanced gastric cancer or gastroesophageal junction cancer: A meta-analysis.
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抗PD-1/抗PD-L1抗体治疗晚期胃癌或胃食管结合部癌的疗效和安全性：荟萃分析
DOI：
10.4251/wjgo.v12.i11.1346
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发表时间：
2020-11-15
影响因子：
3
通讯作者：
Zhang L
中科院分区：
文献类型：
--
作者：
Yang L;Dong XZ;Xing XX;Cui XH;Li L;Zhang L
面对晚期胃癌或胃食管结癌（GC/GEJC）患者有限和不充分的治疗选择，在有希望的临床试验的支持下，研究人员转向了抗pd -1/抗pd - l1抗体治疗。但也有不同的临床试验结果。为了更好地评估其疗效和安全性，我们整合了13项符合条件的研究的数据，进行了系统回顾和荟萃分析。目的综合评价抗pd -1/抗pd - l1抗体治疗晚期GC/GEJC患者的疗效和安全性。方法检索PubMed、Web of Science、Cochrane Library和EMBASE数据库，确定符合条件的文章，包括抗pd -1/抗pd - l1抗体治疗的客观缓解率（ORR）、疾病控制率（DCR）、总生存期（OS）、无进展生存期（PFS）和不良事件（ae）。结果：本研究共纳入13项试验，共计1618例患者。结果显示合并ORR和DCR分别为15%（95%可信区间[CI]: 14%-18%）和40% （95%CI: 33%-46%）。合并的6个月OS和PFS分别为54% （95%CI: 45%-64%）和26% (95%CI: 20%-32%)， 12个月OS和PFS分别为42% （95%CI: 21%-62%）和11% （95%CI: 8%-13%）。此外，任何级别ae和≥3级ae的发生率分别为64% （95%CI: 54%-73%）和18% （95%CI: 16%-20%）。最重要的是，PD-L1阳性患者的ORR率高于PD-L1阴性患者（优势比= 2.54,95%CI: 1.56-4.15）。结论抗pd -1/抗PD-L1抗体治疗在晚期GC/GEJC患者中显示出良好的抗肿瘤疗效和可控的ae， PD-L1过表达患者的ORR更高。更重要的是，抗pd -1/PD-L1联合传统化疗药物的临床疗效更好，尽管ae的发生仍令人担忧。
BACKGROUND Faced with limited and inadequate treatment options for patients with advanced gastric cancer or gastroesophageal junction cancer (GC/GEJC), researchers have turned toward, with the support of promising clinical trials, anti-PD-1/anti-PD-L1 antibody therapy. But there are also different clinical trial results. To better assess its efficacy and safety, we integrated data from 13 eligible studies for a systematic review and meta-analysis. AIM To comprehensively evaluate the efficacy and safety of anti-PD-1/anti-PD-L1 antibody therapy in the treatment of advanced GC/GEJC patients. METHODS PubMed, Web of Science, Cochrane Library ,and EMBASE databases were searched to identify eligible articles with outcomes including objective response rate (ORR), disease control rate (DCR), overall survival (OS), progression-free survival (PFS), and adverse events (AEs) of anti-PD-1/anti-PD-L1 antibody therapy. RESULTS Our study encompassed a total of 13 trials totaling 1618 patients. The outcomes showed a pooled ORR and DCR of 15% (95% confidence interval [CI]: 14%-18%) and 40% (95%CI: 33%-46%), respectively. The pooled 6-mo OS and PFS were 54% (95%CI: 45%-64%) and 26% (95%CI: 20%-32%), respectively, and the 12-mo OS and PFS were 42% (95%CI: 21%-62%) and 11% (95%CI: 8%-13%), respectively. In addition, the incidence of any-grade AEs and grade ≥ 3 AEs was 64% (95%CI: 54%-73%) and 18% (95%CI: 16%-20%), respectively. Most importantly, PD-L1 positive patients exhibited a higher ORR rate than PD-L1 negative patients (odds ratio = 2.54, 95%CI: 1.56-4.15). CONCLUSION Anti-PD-1/anti-PD-L1 antibody therapy has shown promising anti-tumor efficacy with manageable AEs in advanced GC/GEJC patients, with PD-L1 overexpressing patients exhibiting a higher ORR. What is more, the clinical efficacy of anti-PD-1/PD-L1 combined with traditional chemotherapy drugs is even better, although the occurrence of AEs still causes considerate concerns.
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影响因子：
--
作者：
Dong Y;Sun Q;Zhang X
通讯作者：
Zhang X
影响因子：
51.1
作者：
Ford, Hugo E. R.;Marshall, Andrea;Dunn, Janet A.
通讯作者：
Dunn, Janet A.
PD-1和PD-L1检查点信号传导抑制癌症免疫疗法：机制，组合和临床结果。
影响因子：
5.6
作者：
Alsaab HO;Sau S;Alzhrani R;Tatiparti K;Bhise K;Kashaw SK;Iyer AK
通讯作者：
Iyer AK
影响因子：
51.1
作者：
Herbst, Roy S.;Arkenau, Hendrik-Tobias;Chau, Ian
通讯作者：
Chau, Ian
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3.7
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