针对晚期或转移性尿路细胞癌的免疫疗法
Philipp Maisch1,2, Eu Chang Hwang3, Kwangmin Kim4
1Department of Urology, Rechts der Isar Medical Center, Technical University of Munich, Munich, Germany.
The Cochrane database of systematic reviews
|October 9, 2023
概括
免疫检查点抑制剂对一线先进膀癌治疗的存活率几乎没有影响,但在二线治疗中可能会改善存活率. 这些疗法可能会减少严重的不良事件,但不会显著影响生活质量.
科学领域:
- 在瘤学瘤学.
- 免疫治疗是一种免疫疗法.
- 尿路细胞癌是什么意思
背景情况:
- 免疫检查点抑制剂 (ICI) 在治疗晚期和转移性膀癌中至关重要.
- 目前正在进行的研究正在探索ICI作为一线和二线疗法,单独或与化疗结合.
研究的目的:
- 为了比较免疫检查点抑制剂与化疗对晚期或转移性尿路细胞癌的疗效.
- 在一线和二线环境中评估治疗效果.
主要方法:
- 在多个数据库和试验登记册中进行了全面的文献搜索,直到2022年8月.
- 包括随机对照试验 (RCT),将免疫疗法与晚期泌尿腺癌成年人的化疗进行比较.
- 数据使用随机效应模型进行分析,根据GRADE指南对证据确定性进行评分.
主要成果:
- 第一线:ICI对整体存活率几乎没有影响 (HR 0.97),但严重不良事件减少 (RR 0.47).
- 第一线:ICI可能增加了疾病进展的风险 (HR 1.33) 并对生活质量影响不大.
- 第二线:ICI可能会降低整体死亡率 (HR 0.72) 和严重不良事件 (RR 0.89),对疾病进展的影响不确定.
结论:
- 与化疗相比,免疫检查点抑制剂提供了有限的生存益处,作为先进泌尿腺癌的第一线治疗.
- 在二线治疗中,ICI可以提高生存率,并且可能在两种情况下减少严重的不良事件.
- 与健康相关的生活质量似乎不受任何治疗线的免疫治疗的影响.
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