网络对转移性清细胞细胞癌的第二线和超越治疗选择的元分析
Mavis Obeng-Kusi1, Jordyn J Kreutzfeldt2, Ricardo J Estrada-Mendizabal3
1Center for Health Outcomes and Pharmacoeconomic Research, Department of Pharmacy Practice and Science, University of Arizona R. Ken Coit College of Pharmacy, Tucson, AZ.
Urologic oncology
|January 12, 2024
概括
伦瓦提尼布加Everolimus显示,转移性清洁细胞癌的整体存活率和无进展存活率优越. 然而,与安慰剂相比,这种组合和其他有效治疗与严重不良事件的增加有关.
科学领域:
- 在瘤学瘤学.
- 医学研究 医学研究
- 药理学 药理学是指药理学的学科.
背景情况:
- 对转移性清细胞细胞癌 (ccRCC) 进行最佳的二线 (2L) 治疗选择是复杂的.
- 对于可用的2L疗法存在有限的比较数据,特别是考虑到不断发展的第一线 (1L) 选择.
研究的目的:
- 进行网络元分析 (NMA),比较转移性ccRCC的二线治疗方法.
- 评估各种2L疗法的整体存活率 (OS),无进展存活率 (PFS),客观反应率 (ORR) 和严重不良事件 (SAE).
主要方法:
- 对2L转移性ccRCC治疗的II/III期随机对照试验 (RCT) 的系统识别.
- 网络元分析使用正常概率模型来比较包括OS,PFS,ORR和SAE在内的结果.
- 在固定效应模型中,根据从危险比率 (HR) 和赔率比率 (OR) 获得的p-score来对治疗进行排名.
主要成果:
- 与安慰剂相比,伦瓦提尼布加Everolimus在OS,PFS和ORR方面表现出更高的疗效,但SAE增加.
- 卡博桑提尼布在OS,PFS和ORR方面显示出第二好的结果.
- 尼沃卢马布和帕佐帕尼布的严重不良事件发生率最低,而伦瓦提尼布单一治疗与最高的SAE相关.
结论:
- 伦瓦提尼布加Everolimus的组合,其次是卡博赞提尼布和伦瓦提尼布单一治疗,提供了优越的OS和PFS.
- 所有有效的治疗都与严重不良事件的风险增加有关.
- 尼沃卢马布和帕佐帕尼布在严重不良事件方面呈现了最有利的安全概况.
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