晚期肝细胞癌的分子向疗法和免疫疗法:基于随机对照试验的系统综述和贝叶斯网络元分析
Yun-Long Zhang1,2, Xin-Jiang Cui3, Hui Xing3
1School of Medical Imaging, Weifang Medical University, Weifang, Shandong, China.
Annals of medicine
|August 9, 2023
概括
对于晚期肝细胞癌,将PD-1/PD-L1抑制剂与抗VEGF药物 (如阿特佐利祖马布加贝瓦齐祖马布) 结合在一起,显示出更高的疗效. 与索拉芬尼布相比,这些组合疗法提供了更好的整体存活率和无进展存活率.
科学领域:
- 肝胆道癌症 肝胆道癌症
- 医学瘤学 医学瘤学
- 免疫疗法研究研究
背景情况:
- 晚期肝细胞癌 (HCC) 存在重大治疗挑战.
- 索拉费尼布一直是标准的第一线治疗,但需要新的治疗策略.
- 向疗法和免疫疗法已成为HCC的有希望的治疗方式.
研究的目的:
- 系统地比较和排名各种针对性疗法和免疫疗法对高级HCC的疗效.
- 根据生存结果和反应率确定最有效的治疗方案.
- 为高级HCC管理中临床实践提供基于证据的建议.
主要方法:
- 在PubMed,EMBASE和Cochrane图书馆数据库中进行了系统的文献搜索.
- 包括随机对照试验 (RCT),比较系统治疗方案与sorafenib.
- 主要结局包括整体生存 (OS) 和无进展生存 (PFS);次要结局是客观反应率 (ORR) 和安全.
主要成果:
- 分析了29个RCT,包括13376名患者,包括10种单剂和17种组合疗法.
- 与索拉费尼布相比,辛提利马布加IBI305,卡梅利祖马布加利沃塞拉尼布和阿特佐利祖马布加贝瓦西祖马布的生存状况更好.
- 这些排名最高的疗法代表了PD-1/PD-L1抑制剂与抗VEGF药物的组合.
结论:
- 与PD-1/PD-L1抑制剂和抗VEGF药物的联合治疗为晚期HCC提供了优越的治疗效果.
- 进一步开发联合向和免疫治疗方法是有必要的,以改善患者的治疗结果.
- 这些发现支持了在先进的HCC中新型组合策略的临床效用.
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