免疫检查点抑制剂在肛门鳞状细胞癌中的应用:一项系统综述和荟萃分析

IF 3 3区 医学 Q2 ONCOLOGY Seminars in oncology Pub Date : 2023-11-24 DOI:10.1053/j.seminoncol.2023.11.002
Laura Pala, Tommaso De Pas, Erika Stucchi, Chiara Catania, Emilia Cocorocchio, Maria Giulia Zampino, Giovanna Rossi, Emma Zattarin, Antonio Di Muzio, Daniele Laszlo, Sara Stucchi, Fabio Conforti
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引用次数: 0

摘要

肛门鳞状细胞癌(SCCA)是一种罕见的肿瘤。虽然大多数局部晚期患者可以通过化疗治愈,但大约四分之一的患者最终会出现转移性复发。晚期疾病的标准治疗是化疗,但最近有证据表明免疫疗法具有活性。我们对SCCA患者免疫检查点抑制剂(ICIs)的前瞻性试验进行了系统回顾和荟萃分析。目的评价ICIs治疗晚期SCCA患者的总有效率(ORR)和疾病控制率(DCR)。方法系统检索PubMed、Embase和Scopus,截至2022年12月31日,以评估晚期SCCA患者的ICIs的前瞻性试验。主要和次要终点分别为ORR和DCR。结果6项前瞻性试验纳入分析,其中1项为随机试验。总共分析了7个治疗组和347名患者。5个治疗组将ICIs作为单一疗法进行测试,2个治疗组分别将ICIs与西妥昔单抗和贝伐单抗联合进行测试。合并ORR为13% (95%CI, 10%-17%), DCR为57% (95%CI, 40%-74%)。敏感性分析的结果没有改变,该分析排除了两个治疗组测试ICIs与其他药物联合使用的结果。结论ICIs治疗scca的疗效较低。联合靶向药物或化疗可能是这些患者更好的治疗策略。进一步的研究有待于确定对ICIs的耐药机制并优化其疗效。
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Immune-checkpoint inhibitors in anal squamous cell carcinoma: a systematic review and meta-analysis

Introduction

Squamous cell carcinoma of the anus (SCCA) is a rare tumor. While most patients with locally advanced disease are cured with chemo-radiotherapy, about a quarter eventually experience metastatic recurrence. Standard treatment for advanced disease is chemotherapy, but recently evidence on the activity of immunotherapy has been reported. We performed a systematic review and meta-analysis of prospective trials testing immune-checkpoint inhibitors (ICIs) in patients with SCCA.

Objective

We aimed to evaluate the overall response rate (ORR) and the disease control rate (DCR) of ICIs in patients with advanced SCCA.

Methods

We systematically searched PubMed, Embase, and Scopus, through December 31, 2022, for prospective trials assessing ICIs in patients with advanced SCCA. The primary and secondary endpoints were respectively ORR and DCR.

Results

Six prospective trials were included in the analysis, one of which was randomized. Overall, seven treatment arms and 347 patients have been analyzed. Five treatment arms tested ICIs as monotherapy and two arms examined ICIs in combination with cetuximab and bevacizumab, respectively. The pooled ORR was 13% (95%CI, 10%–17%), with a DCR of 57% (95%CI, 40%–74%). Results did not change in a sensitivity analysis, which excluded the two treatment arms testing the combination of ICIs with other drugs.

Conclusions

The efficacy of ICIs in SCCAs is low. Combination strategies with targeted drugs or chemotherapy might represent a better therapeutic strategy for these patients. Further studies are awaited to identify resistance mechanisms to ICIs and optimize their efficacy.

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来源期刊
Seminars in oncology
Seminars in oncology 医学-肿瘤学
CiteScore
6.60
自引率
0.00%
发文量
58
审稿时长
104 days
期刊介绍: Seminars in Oncology brings you current, authoritative, and practical reviews of developments in the etiology, diagnosis and management of cancer. Each issue examines topics of clinical importance, with an emphasis on providing both the basic knowledge needed to better understand a topic as well as evidence-based opinions from leaders in the field. Seminars in Oncology also seeks to be a venue for sharing a diversity of opinions including those that might be considered "outside the box". We welcome a healthy and respectful exchange of opinions and urge you to approach us with your insights as well as suggestions of topics that you deem worthy of coverage. By helping the reader understand the basic biology and the therapy of cancer as they learn the nuances from experts, all in a journal that encourages the exchange of ideas we aim to help move the treatment of cancer forward.
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