免疫疗法为基础的组合在一线泌尿道癌:一个系统的审查和个体患者数据 (IPD) 的元分析
Mattia Alberto Di Civita1,2, Andrea Torchia3, Daniele Santini4,5
1Department of Experimental Medicine, Sapienza University, 00161 Rome, Italy.
Current oncology (Toronto, Ont.)
|August 28, 2024
概括
在EV302试验中,在接受免疫疗法加化疗治疗的晚期泌尿腺癌 (mUC) 患者中,表现出优异的整体存活率 (OS) 和无进展存活率 (PFS). 与单独的化疗相比,这种组合策略显示出有前途.
科学领域:
- 在瘤学瘤学.
- 临床试验 临床试验
- 免疫治疗是一种免疫疗法.
背景情况:
- 基于的化疗是先进泌尿道癌 (mUC) 一线治疗的标准治疗方法.
- 结合免疫检查点抑制剂 (ICI) 与化疗的疗效正在研究中.
研究的目的:
- 为了比较基于ICI的治疗在晚期泌尿腺癌的有效性.
- 对评估ICI加化疗的第三阶段临床试验进行个人患者数据 (IPD) 分析.
主要方法:
- 在MEDLINE和CENTRAL数据库 (2018-2023) 中进行系统的文献搜索.
- 包括四个第三阶段临床试验 (EV302,CHECKMATE-901,IMVIGOR130,KEYNOTE-361) 与3047名患者进行.
- 通过重建卡普兰-梅尔曲线数据进行的IPD元分析;主要终点:总生存率 (OS) 和无进展生存率 (PFS).
主要成果:
- 与其他试验相比,EV302手臂在OS方面显示出显著的优势 (HR 0.51与KEYNOTE-361,HR 0.47与IMVIGOR130,HR 0.66与CHECKMATE-901).
- 在统计学上,EV302比CHECKMATE-901 (HR 0.66) 和IMVIGOR130 (HR 0.51) 具有显著的PFS优势.
- EV-Pembrolizumab显示出比avelumab和其他免疫化学疗法组合更好的结果.
结论:
- 与其他免疫化学疗法组合相比,EV302实验组在mUC.中表现出优异的OS和PFS.
- 免疫化疗组合策略在第一线mUC治疗中似乎优于单独基于的化疗.
- 由于研究异质性,需要进一步的后续和前性试验来证实这些发现.
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