1. 抗PD-1/PD-L1治疗在胃癌或胃食管结合部腺癌中的疗效荟萃分析.
- Author
-
张颖, 魏雨涵, 李莉, and 曹邦伟
- Subjects
- *
CLINICAL trials , *ESOPHAGOGASTRIC junction , *PROGRESSION-free survival , *PROGRAMMED cell death 1 receptors , *MONOCLONAL antibodies , *GROUP psychotherapy - Abstract
OBJECTIVE: To systematically evaluate the efficacy of programmed death-1/programmed death ligand-1( PD-1/PD-L1) monoclonal antibody in gastric cancer or adenocarcinoma of the gastroesophageal junction.METHODS: PubMed,Embase,the Cochrane Library database and abstracts of American society of clinical oncology( ASCO) conferences in the past three years,and European society for medical oncology( ESMO) conferences in 2020 were retrieved to collect the prospective studies,phase Ⅱ and phase Ⅲ clinical trials( the study group was treated with PD-1/PD-L1 monoclonal antibody alone or in combination with chemotherapy,while the control group received chemotherapy or placebo. The retrieval deadline was Sept. 26 th,2020. The efficacy of different treatment regimens( PD-1/PD-L1 monoclonal antibody treatment group compared with chemotherapy group,PD-1/PD-L1 monoclonal antibody treatment + chemotherapy group compared with chemotherapy group,and PD-1/PD-L1 monoclonal antibody treatment group compared with placebo group) was assessed by subgroup analysis,and forest plotting was performed by Stata SE 12 software. RESULTS: Seven clinical trials were ultimately enrolled,including three original papers,two abstracts of ASCO conferences and two abstracts of ESMO conferences.( 1) The differences in overall survival( OS)( HR = 0. 96,95% CI = 0. 87-1. 07,P = 0. 451) and objective response rate( ORR)( RR = 0. 65,95% CI = 0. 39-1. 09,P = 0. 102) between the PD-1/PD-L1 monoclonal antibody treatment group alone and the chemotherapy group were not statistically significant,yet the difference in progression free survival( PFS) between two groups was statistically significant( HR = 1. 45,95% CI = 1. 17-1. 81,P = 0. 001).( 2) The differences of OS( HR = 0. 84,95% CI = 0. 76-0. 94,P = 0. 001),PFS( HR = 0. 78,95% CI = 0. 70-0. 86,P = 0. 000) and ORR( RR = 1. 24,95% CI = 1. 10-1. 39,P = 0. 000) between the PD-1/PD-L1 monoclonal antibody treatment + chemotherapy group and the chemotherapy group were statistically significant.( 3) The differences of OS( HR = 0. 63,95% CI = 0. 51-0. 78,P = 0. 000),PFS( HR = 0. 60,95% CI = 0. 49-0. 75,P = 0. 000) and ORR( RR = 29. 93,95% CI = 1. 84-485. 72,P = 0. 017)between the PD-1/PD-L1 monoclonal antibody treatment group and the placebo group were statistically significant.CONCLUSIONS: The results of this study suggest that PD-1/PD-L1 monoclonal antibody combined with chemotherapy may benefit patients with advanced gastric cancer or adenocarcinoma of the gastroesophageal junction.Compared with placebo,PD-1/PD-L1 monoclonal antibody alone also benefits patients with advanced gastric cancer or adenocarcinoma of the gastroesophageal junction. However,compared with chemotherapy,patients with advanced gastric cancer or adenocarcinoma of the gastroesophageal junction may not get a more significant treatment effect from PD-1/PD-L1 monoclonal antibody,and more evidence is needed to confirm these findings. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF