吸烟对肺癌免疫疗法的影响:系统性审查和元分析
Dachen Luo1, Dongmei Yang1, Dan Cao1
1Department of Respiratory and Critical Care Medicine, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China.
Frontiers in oncology
|October 23, 2024
概括
吸烟史不会影响免疫检查点抑制剂 (ICI) 对晚期肺癌的有效性. 这一元分析证实免疫疗法对吸烟者和不吸烟者都有好处,无论吸烟状态如何.
科学领域:
- 在瘤学瘤学.
- 免疫治疗是一种免疫疗法.
- 临床试验 临床试验
背景情况:
- 关于吸烟史与免疫检查点抑制剂 (ICI) 在晚期肺癌中的有效性之间的关系存在相互矛盾的证据.
- 一些研究表明,吸烟可以增强免疫疗法反应,而另一些研究则表明相反.
研究的目的:
- 进行系统审查和元分析,以澄清吸烟史与ICI在晚期肺癌中的有效性之间的关联.
- 根据吸烟状况 (从未吸烟者与吸烟者,前吸烟者与现吸烟者) 调查免疫治疗反应的疗效差异.
主要方法:
- 在PubMed,Embase和Scopus系统搜索相关的临床试验.
- 使用随机效应模型对整体生存 (OS) 的危险比率 (HRs) 的元分析.
- 基于吸烟状态和治疗方式的预定义子组分析.
主要成果:
- 分析包括17项III期试验,包括10,283名患者.
- 免疫疗法对吸烟者 (HR:0.74) 和从未吸烟者 (HR:0.73) 均显示出显著的生存益处,没有显著的相互作用效应 (p=0.14).
- 前吸烟者 (HR:0.79) 和目前吸烟者 (HR:0.71) 也显示出显著的生存益处,没有显著的相互作用效应 (p=0.14).
结论:
- 吸烟状态似乎不会影响免疫治疗在晚期肺癌治疗中的有效性.
- 需要进一步进行高质量的临床试验来巩固这些发现.
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