免疫检查点抑制剂作为高级头癌的第一线治疗
Yan Huang1, Hong Zhou2, Guangyong Zhao3
1Department of Radiotherapy, The Affiliated Changzhou No.2 People's Hospital of Nanjing Medical University, Changzhou, China.
The Laryngoscope
|August 23, 2023
概括
免疫检查点抑制剂 (ICI) 与化疗相结合,对晚期头癌 (HNC) 显示出有前途. 布罗利祖马布加化疗提供最好的整体生存率和反应率,而杜尔瓦卢马布的不良反应最少.
科学领域:
- 在瘤学瘤学.
- 免疫治疗是一种免疫疗法.
- 头部和部癌症研究研究
背景情况:
- 免疫检查点抑制剂 (ICI) 治疗对某些癌症患者提供了显著的益处.
- 评估不同ICI方案的比较疗效和安全性对于优化临床治疗策略至关重要.
研究的目的:
- 进行一个网络元分析,比较各种ICI单疗法和高级头癌 (HNC) 的组合疗法.
- 评估不同免疫疗法的优点和缺点,重点关注生存结果和与治疗相关的不良事件 (TRAEs).
主要方法:
- 在PubMed,Embase和Cochrane数据库中进行了全面的文献搜索,搜索到2023年6月10日发布的随机临床试验 (RCT).
- 包含的RCT涉及ICI单疗或组合疗法,并提取了关于生存疗效和TRAE的数据.
- 贝叶斯随机效应模型被用于19个涉及5900名患者的RCT的网络元分析 (NMA).
主要成果:
- 布罗利祖马布加化学疗法显示了整体存活率 (OS) 和客观响应率 (ORR) 的最高潜力.
- 托里帕利马布加化学疗法显示,改善无进展生存率 (PFS) 的可能性最大.
- 杜尔瓦卢马布表现出最少的不良事件发生率,表明了有利的安全概况,而Camrelizumab加上化疗与更高的风险有关. 在ORR和安全性方面,双重ICI治疗 (Nivolumab/Ipilimumab) 的表现优于Durvalumab/Tremelimumab. 标准护理 (SOC) 方案在所有评估结果中表现不佳.
结论:
- 结合化疗和ICI显著提高了作为先进HNC的第一线治疗的疗效.
- 特定的ICI组合在生存结果和安全方面具有明显的优势,指导个性化治疗选择.
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