摘要
目的运用荟萃分析的方法比较程序细胞死亡蛋白-1(PD-1)及其配体(PD-L1)免疫检查点抑制剂与多西他赛治疗晚期非小细胞肺癌(NSCLC)的有效性。方法计算机检索CNKI、万方、维普、CBM、PubMed、EMBASE、Corchrane library、Web of Science等数据库,收集截至2021年5月公开发表的关于PD-1/PD-L1免疫检查点抑制剂与多西他赛治疗晚期NSCLC的随机对照试验(RCTs)。由2名研究员独立进行检索,根据纳入与排除标准筛选文献,提取数据,采用RevMan5.3软件对纳入的研究进行统计学分析和异质性检验。如有争议,由2名研究员讨论解决。结果共纳入12项RCTs,其中使用PD-1/PD-L1免疫检查点抑制剂治疗的有4684例,使用多西他赛治疗的有4610例。与多西他赛相比,使用PD-1/PD-L1免疫检查点抑制剂治疗晚期NSCLC的总生存期(HR=0.73,95%CI:0.69~0.77,P<0.00001)和无进展生存期(HR=0.88,95%CI:0.80~0.96,P=0.004)更长,疗效更好。结论与多西他赛相比,PD-1/PD-L1免疫检查点抑制剂治疗可提高晚期NSCLC患者的临床疗效,这种疗法对晚期NSCLC患者可能是一种有前景的治疗方法。结论仍需多中心、大样本、高质量的研究进一步证实。
Objective To compare the efficacy of anti-PD-1/PD-L1 inhibitors against docetaxel in the treatment of advanced non-small cell lung cancer(NSCLC)by meta-analysis.Methods The randomized controlled trials(RCTs)of anti-PD-1/PD-L1 inhibitors and docetaxel in the treatment of NSCLC published until May 2021 were collected via searching CNKI,Wanfang,VIP,CBM,PubMed,EMBASE,Cochrane Library and Web of Science databases.Two reviewers independently conducted literature retrieval,screened literature and extracted data according to unified quality criteria.Then RevMan5.3 was used to perform statistical analysis and heterogeneity test.Any disputes were resolved through discussion.Results A total of 12 RCTs were included,including 4684 patients treated with anti-PD-1/PD-L1 inhibitors and 4610 patients treated with docetaxel.Treatments with anti-PD-1/PD-L1 inhibitors resulted in longer overall survival(HR=0.73,95%CI:0.69–0.77,P<0.00001)and progression-free survival(HR=0.88,95%CI:0.80–0.96,P=0.004)when compared with docetaxel,and their clinical effect is better.Conclusion Compared with docetaxel,anti-PD-1/PD-L1 inhibitors improves clinical efficacy.This therapy could be a promising treatment for patients with advanced NSCLC.The results still need to be confirmed by a multi-center,large sample,and high-quality research.
作者
金刚
姚可盈
神兴伟
马龙
朱自江
Jin Gang;Yao Keying;Shen Xingwei;Ma Long;Zhu Zijiang(Second Department of Thoracic Surgery,Gansu Provincial Hospital,Lanzhou 730000,China;The Second Clinical Medical College of Lanzhou University,Lanzhou 730000,China;The First Clinical Medical College of Gansu University of Chinese Medicine(Gansu Provincial Hospital),Lanzhou 730000,China)
出处
《中华胸部外科电子杂志》
2021年第4期239-246,共8页
CHINESE JOURNAL OF THORACIC SURGERY：Electronic Edition
基金
国家自然科学基金(31760259)。
