对HPV相关的宫恶性瘤的治疗性疫苗:系统性审查
Souhail Alouini1,2, Chantal Pichon3,4
1Departement of Gynecological Surgery, Centre Hospitalier Universitaire d'Orléans, 14 Avenue de l'Hôpital, 45100 Orleans, France.
Vaccines
|April 27, 2024
概括
治疗性疫苗显示出逆转2级和3级宫内皮质瘤 (CIN) 的潜力. 然而,对于晚期宫癌治疗的证据仍然有限,这凸显了进一步研究的需要.
科学领域:
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
- 疫苗学 疫苗学 疫苗学
背景情况:
- 宫癌仍然是一个重要的全球卫生问题,尽管预防性疫苗接种.
- 正在探索治疗性疫苗作为HPV相关的宫恶性瘤的补充治疗方法.
研究的目的:
- 系统地审查随机对照试验 (RCT),评估治疗性疫苗治疗宫癌和2级和3级宫内皮质瘤 (CIN).
- 评估这些治疗疫苗的疗效和安全性.
主要方法:
- 对PubMed,Embase和Cochrane控制试验中央注册表进行了系统的搜索,搜索到2024年1月31日之前发表的英语文章.
- 包括9个涉及800名参与者的RCT,数据基于疫苗疗效终点如病变回归,临床反应和整体存活率进行合成.
- 使用GRADE方法评价证据确定性.
主要成果:
- 在CIN2/3上进行的7个RCT (677名参与者) 显示,使用治疗性疫苗显著的损伤回归 (p=0.010) 的中度确定性证据.
- 关于晚期子宫癌的两个RCT (123名参与者) 报告了非显著的临床反应和整体存活率,证据确定性非常低.
- 所有包括的研究都报告了良好的疫苗耐受性.
结论:
- 治疗性疫苗显示出诱导CIN2和CIN3病变回归的潜力.
- 在患有晚期宫癌的患者中,治疗性疫苗的疗效存在显著的证据差距,这是由于RCT的数量非常少.
- 进一步的研究是有必要的,以探索治疗性疫苗在晚期宫癌的疗效.
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