针对晚期非清晰细胞细胞癌的全身治疗的有效性:系统性审查和元分析
Yaping Zhang1, Jian Chen2, Xiaoyan Wang1
1Department of Oncology, Affliated Xiaoshan Hospital, Hangzhou Normal University, Hangzhou, China.
Frontiers in oncology
|January 2, 2025
概括
血管内皮生长因子受体氨酸激酶抑制剂 (VEGFR-TKIs) 与哺乳动物目标拉巴胺素抑制剂 (mTORi) 相比,在一线非清细胞脏细胞癌 (nccRCC) 治疗中改善无进展生存率 (PFS). 在PD-L1阳性患者中,组合疗法和免疫检查点抑制剂 (ICI) 显示出有希望的响应率.
科学领域:
- 在瘤学瘤学.
- 医学研究 医学研究
- 临床试验 临床试验
背景情况:
- 非清细胞细胞癌 (nccRCC) 是一种多样化的癌症,其最佳治疗策略尚不清楚.
- 目前的治疗方法通常基于清细胞细胞癌 (ccRCC) 的证据.
- 这项研究通过比较主流药物治疗,为先进的nccRCC提供了临床指导.
研究的目的:
- 为了比较当前主流药物治疗对于晚期非清细胞细胞癌 (nccRCC) 的疗效.
- 为nccRCC患者提供临床治疗指南.
- 评估整体应答率 (ORR),疾病控制率 (DCR),无进展生存率 (PFS) 和整体生存率 (OS).
主要方法:
- 在PubMed,Embase和Cochrane数据库中进行系统搜索,截至2024年1月2日.
- 包括受控试验和单臂试验.
- 六项随机对照试验 (RCT) 的元分析,比较哺乳动物目标拉巴胺素抑制剂 (mTORi) 和血管内皮生长因子受体氨酸激酶抑制剂 (VEGFR-TKI).
- 对VEGFR-TKI,mTORi,免疫检查点抑制剂 (ICI),化疗和组合治疗试验的单臂元分析.
主要成果:
- 在一线治疗中,VEGFR-TKIs显著改善了PFS而不是mTORi (RR = 1.387,p = 0.026).
- 聚合ORR在6%至36%之间,聚合DCR在54%至81%之间.
- 免疫检查点抑制剂 (ICI) 在PD-L1阳性患者的ORR比PD-L1阴性患者高 (RR = 3.044,p = 0.001).
结论:
- 与mTORi相比,VEGFR-TKI在一线nccRCC治疗中增强了PFS.
- 组合疗法显示改善了ORR和DCR.
- 在nccRCC中,PD-L1阳性与对ICI的优异治疗反应有关.
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