雷戈拉菲尼布加编程死亡-1 抑制剂与雷戈拉菲尼布单疗法在晚期肝细胞癌的二线治疗中:系统性审查和元分析
Zhao Li1, Jie Wang1, Jingbing Zhao1
1Department of Hepato-Biliary-Pancreas II, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, P.R. China.
Oncology letters
|May 29, 2024
概括
与单独使用雷戈拉菲尼布相比,雷戈拉菲尼布加编程死亡-1 抑制剂 (R-P) 治疗显著改善了晚期肝细胞癌 (HCC) 患者的生存率和瘤反应. 然而,R-P治疗与更高的不良事件发生率有关.
科学领域:
- 肝胆瘤学 肝胆瘤学
- 医学瘤学 医学瘤学
- 免疫治疗是一种免疫疗法.
背景情况:
- 晚期肝细胞癌 (HCC) 是一个重大的治疗挑战.
- 晚期HCC的二线治疗选择仍然有限,需要新的治疗策略.
研究的目的:
- 为了比较regorafenib加编程死亡-1抑制剂 (R-P) 与regorafenib单一治疗作为高级HCC的二线治疗的疗效和安全性.
- 评估RP治疗对整体存活率,无进展存活率,瘤反应和不良事件的影响.
主要方法:
- 在PubMed,Embase,Web of Science和Cochrane图书馆数据库中进行了系统的文献搜索,直到2023年10月.
- 用Stata/MP 17.0.0.进行了对5项队列研究的元分析,其中包括444名患有晚期HCC的患者,使用Stata/MP 17.0.0.
- 数据提取和选由两位作者按照标准化协议独立进行.
主要成果:
- 与单独使用雷戈拉费尼布治疗相比,R-P治疗显示出改善的整体存活率 (HR,0.61;95% CI 0.48-0.77) 和无进展存活率 (HR,0.51;95% CI 0.41-0.63).
- 客观应答率 (RR, 2.33;95% CI 1.49-3.64) 和疾病控制率 (HR, 1.40;95% CI 1.20-1.63) 在R-P组显著更高.
- 随着RP治疗,观察到不良事件的发生率增加,包括甲状腺功能低下症,血小板减少和皮疹.
结论:
- 与reorafenib单独治疗相比,regorafenib加编程死亡-1抑制剂 (R-P) 疗法在先进的HCC患者中提供了优越的生存益处和增强的瘤反应.
- 虽然R-P治疗显示出更好的疗效,但需要仔细监测甲状腺功能低下,血小板减少和皮疹等不良事件.
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