晚期NSCLC患者免疫治疗的3级以上的血液学不良事件:系统性审查和元分析
Shuang Wang1, Mengting Cai1, Yajun Xiong1
1Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
European journal of clinical pharmacology
|January 22, 2025
概括
免疫检查点抑制剂 (ICI) 单独对高级非小细胞肺癌 (NSCLC) 患者是安全的,减少骨髓抑制. 然而,将ICI与化疗相结合会增加严重血小板缺血的风险.
科学领域:
- 在瘤学瘤学.
- 免疫治疗是一种免疫疗法.
- 血液学 血液学 血液学
背景情况:
- 免疫检查点抑制剂 (ICI) 与晚期非小细胞肺癌 (NSCLC) 中的化疗相结合的安全性需要澄清.
- 骨髓抑制是NSCLC治疗的一个重要问题.
研究的目的:
- 评估免疫检查点抑制剂 (ICI) 对晚期非小细胞肺癌 (NSCLC) 骨髓抑制的影响.
- 为了比较基于ICI的疗法和单独的化疗之间的血液学不良事件的风险.
主要方法:
- 对23项3期随机对照试验 (RCT) 的系统审查和元分析,涉及15844名NSCLC患者.
- 在PubMed,科学网,Embase和Cochrane图书馆搜索到2023年10月.
- 对3级或更高的与治疗相关的血液学不良事件的评估风险比率 (RR).
主要成果:
- 与单独化学疗法相比,ICI单疗法或双免疫疗法显著降低了白血病,中性质衰竭,血小板衰竭和贫血的风险.
- 结合ICI和化疗增加了严重血小板缺血的风险 (RR 1.35),但并没有显著增加白血病,中性质缺血或贫血的风险.
结论:
- 严重的血液学不良事件是不常见的ICI单疗在先进的NSCLC.
- 将ICI与化疗相结合可能会加剧骨髓抑制,特别是增加严重血小板缩的发生率.
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