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针对性和免疫组合疗法的安全性和有效性分析在先进的黑色素瘤系统性审查和网络元分析中

Anna Sára Lengyel^1,2,3,4, Fanni Adél Meznerics^1,2, Noémi Ágnes Galajda^1,2

¹Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, 1085 Budapest, Hungary.

International journal of molecular sciences

|December 17, 2024

概括

结合BRAF,MEK和PD1/PDL1抑制剂的三重治疗改善了晚期黑色素瘤的无进展生存率,但增加了副作用. 单疗法和BRAF/MEK组合更安全,需要进一步的试验以获得最佳的三重疗法使用.

科学领域:

在瘤学瘤学.
皮肤病学皮肤病学
药理学药理学是指药理学的学科.

背景情况:

基于BRAF抑制剂的向疗法与免疫检查点抑制剂相结合,是晚期黑色素瘤的新兴治疗方法.
评估当前黑色素瘤治疗的安全性和有效性对于优化患者的治疗结果至关重要.

研究的目的:

系统地审查和网络分析各种治疗晚期黑色素瘤的安全性和有效性.
将组合疗法 (BRAF/MEK 抑制剂 + 免疫检查点抑制剂) 与其他治疗方式进行比较.

主要方法:

在四个数据库中系统搜索高级/转移性黑色素瘤的随机临床研究.
包括关于化疗,免疫检查点抑制剂,BRAF/MEK抑制剂及其组合的研究.
主要终点包括不良事件,停药,无进展生存率和反应率.

主要成果:

三重疗法 (BRAF,MEK,PD1/PDL1抑制) 在BRAF突变黑色素瘤中显示了比BRAF+MEK组合更长的无进展生存期.
在三重疗法和BRAF + MEK组合之间,客观和完全响应率相似.
三重疗法显示严重不良事件和中止率与联合BRAF/MEK和ICI疗法相比相当,但与单一疗法和BRAF/MEK组合相比,与治疗相关的不良事件更高.

结论:

涉及BRAF/MEK向疗法和免疫检查点抑制剂的组合策略是高级BRAF突变黑色素瘤的有效一线选择.
这些组合疗法与增加的副作用有关.
需要进一步的随机对照试验来确定可能从三重疗法中受益最多的高风险亚群.

关键词:

晚期的黑色素瘤是什么免疫检查点抑制剂免疫检查点抑制剂网络元分析网络元分析有针对性的治疗.三重治疗是三重疗法.

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