{"title":"彭博利珠单抗治疗晚期或复发性宫颈癌的疗效和安全性的 Meta 分析。","authors":"Xue Zhang, Wen-Jie Yin, Ai-Li Zhang, Xiao-Xiao Zhang, Li-Juan Ding, Jiao Zhang, Shu-Ting He, Jie-Ping Yan","doi":"10.1080/01443615.2024.2390564","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>This meta-analysis seeks to assess the efficacy and safety of pembrolizumab in individuals with advanced or recurrent cervical cancer.</p><p><strong>Methods: </strong>Databases from PubMed, Embase, and the Cochrane Library were all thoroughly searched for pertinent research. Outcomes include complete response (CR), partial response (PR), stable disease (SD), disease progression (PD), overall response rate (ORR), disease control rate (DCR), median progression-free survival (mPFS), median overall survival (mOS), and adverse events (AEs) were retrieved for further analysis.</p><p><strong>Results: </strong>Ten trials with 721 patients were included in this meta-analysis. The pooled results for patients with cervical cancer receiving pembrolizumab were as follows: CR (0.06, 95%CI: 0.02-0.10), PR (0.15, 95%CI: 0.08-0.22), SD (0.16, 95%CI: 0.13-0.20), PD (0.50, 95%CI: 0.25-0.75), ORR (0.26, 95%CI: 0.11-0.41) and DCR (0.42, 95%CI: 0.13-0.71), respectively. Regarding survival analysis, the pooled mPFS and mOS were 3.81 and 10.15 months. Subgroup analysis showed that pembrolizumab in combination was more beneficial in CR (0.16 vs. 0.03, <i>p</i> = 0.012), PR (0.24 vs. 0.08, <i>p</i> = 0.032), SD (0.11 vs. 0.19, <i>p</i> = 0.043), ORR (0.42 vs. 0.11, <i>p</i> = 0.014), and mPFS (5.54 months vs. 2.27 months, <i>p</i> < 0.001) than as single agent. The three most common AEs were diarrhoea (0.25), anaemia (0.25), and nausea (0.21), and the incidence of grade 3-5 AEs was significantly lower, rarely surpassing 0.10.</p><p><strong>Conclusions: </strong>For patients with advanced or recurrent cervical cancer, this systematic review and meta-analysis demonstrated that pembrolizumab had a favourable efficacy and tolerability. Future research will primarily focus on optimising customised regiments that optimally integrate pembrolizumab into new therapies and combination strategies. Designed to maximise patient benefit and efficiently control adverse effects while maintaining a high standard of living.</p>","PeriodicalId":16627,"journal":{"name":"Journal of Obstetrics and Gynaecology","volume":"44 1","pages":"2390564"},"PeriodicalIF":0.9000,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Meta-analysis of efficacy and safety of pembrolizumab for the treatment of advanced or recurrent cervical cancer.\",\"authors\":\"Xue Zhang, Wen-Jie Yin, Ai-Li Zhang, Xiao-Xiao Zhang, Li-Juan Ding, Jiao Zhang, Shu-Ting He, Jie-Ping Yan\",\"doi\":\"10.1080/01443615.2024.2390564\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>This meta-analysis seeks to assess the efficacy and safety of pembrolizumab in individuals with advanced or recurrent cervical cancer.</p><p><strong>Methods: </strong>Databases from PubMed, Embase, and the Cochrane Library were all thoroughly searched for pertinent research. Outcomes include complete response (CR), partial response (PR), stable disease (SD), disease progression (PD), overall response rate (ORR), disease control rate (DCR), median progression-free survival (mPFS), median overall survival (mOS), and adverse events (AEs) were retrieved for further analysis.</p><p><strong>Results: </strong>Ten trials with 721 patients were included in this meta-analysis. The pooled results for patients with cervical cancer receiving pembrolizumab were as follows: CR (0.06, 95%CI: 0.02-0.10), PR (0.15, 95%CI: 0.08-0.22), SD (0.16, 95%CI: 0.13-0.20), PD (0.50, 95%CI: 0.25-0.75), ORR (0.26, 95%CI: 0.11-0.41) and DCR (0.42, 95%CI: 0.13-0.71), respectively. Regarding survival analysis, the pooled mPFS and mOS were 3.81 and 10.15 months. Subgroup analysis showed that pembrolizumab in combination was more beneficial in CR (0.16 vs. 0.03, <i>p</i> = 0.012), PR (0.24 vs. 0.08, <i>p</i> = 0.032), SD (0.11 vs. 0.19, <i>p</i> = 0.043), ORR (0.42 vs. 0.11, <i>p</i> = 0.014), and mPFS (5.54 months vs. 2.27 months, <i>p</i> < 0.001) than as single agent. The three most common AEs were diarrhoea (0.25), anaemia (0.25), and nausea (0.21), and the incidence of grade 3-5 AEs was significantly lower, rarely surpassing 0.10.</p><p><strong>Conclusions: </strong>For patients with advanced or recurrent cervical cancer, this systematic review and meta-analysis demonstrated that pembrolizumab had a favourable efficacy and tolerability. Future research will primarily focus on optimising customised regiments that optimally integrate pembrolizumab into new therapies and combination strategies. Designed to maximise patient benefit and efficiently control adverse effects while maintaining a high standard of living.</p>\",\"PeriodicalId\":16627,\"journal\":{\"name\":\"Journal of Obstetrics and Gynaecology\",\"volume\":\"44 1\",\"pages\":\"2390564\"},\"PeriodicalIF\":0.9000,\"publicationDate\":\"2024-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Obstetrics and Gynaecology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1080/01443615.2024.2390564\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/8/16 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q4\",\"JCRName\":\"OBSTETRICS & GYNECOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Obstetrics and Gynaecology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/01443615.2024.2390564","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/8/16 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
背景本荟萃分析旨在评估pembrolizumab对晚期或复发性宫颈癌患者的疗效和安全性:对PubMed、Embase和Cochrane图书馆的数据库进行了全面检索,以寻找相关研究。检索结果包括完全反应(CR)、部分反应(PR)、疾病稳定(SD)、疾病进展(PD)、总反应率(ORR)、疾病控制率(DCR)、中位无进展生存期(mPFS)、中位总生存期(mOS)和不良事件(AEs),以便进一步分析:本次荟萃分析共纳入10项试验,721名患者。接受pembrolizumab治疗的宫颈癌患者的汇总结果如下:分别为CR(0.06,95%CI:0.02-0.10)、PR(0.15,95%CI:0.08-0.22)、SD(0.16,95%CI:0.13-0.20)、PD(0.50,95%CI:0.25-0.75)、ORR(0.26,95%CI:0.11-0.41)和DCR(0.42,95%CI:0.13-0.71)。在生存期分析方面,汇总的mPFS和mOS分别为3.81个月和10.15个月。亚组分析显示,pembrolizumab联合用药在CR(0.16 vs. 0.03,p = 0.012)、PR(0.24 vs. 0.08,p = 0.032)、SD(0.11 vs. 0.19,p = 0.043)、ORR(0.42 vs. 0.11,p = 0.014)和mPFS(5.54个月 vs. 2.27个月,p 结论:pembrolizumab联合用药对晚期或复发性癌症患者的生存期更有利:对于晚期或复发性宫颈癌患者,本系统综述和荟萃分析表明,pembrolizumab具有良好的疗效和耐受性。未来的研究将主要集中于优化定制方案,将 pembrolizumab 与新疗法和联合策略进行最佳整合。旨在使患者受益最大化,有效控制不良反应,同时保持较高的生活水平。
Meta-analysis of efficacy and safety of pembrolizumab for the treatment of advanced or recurrent cervical cancer.
Background: This meta-analysis seeks to assess the efficacy and safety of pembrolizumab in individuals with advanced or recurrent cervical cancer.
Methods: Databases from PubMed, Embase, and the Cochrane Library were all thoroughly searched for pertinent research. Outcomes include complete response (CR), partial response (PR), stable disease (SD), disease progression (PD), overall response rate (ORR), disease control rate (DCR), median progression-free survival (mPFS), median overall survival (mOS), and adverse events (AEs) were retrieved for further analysis.
Results: Ten trials with 721 patients were included in this meta-analysis. The pooled results for patients with cervical cancer receiving pembrolizumab were as follows: CR (0.06, 95%CI: 0.02-0.10), PR (0.15, 95%CI: 0.08-0.22), SD (0.16, 95%CI: 0.13-0.20), PD (0.50, 95%CI: 0.25-0.75), ORR (0.26, 95%CI: 0.11-0.41) and DCR (0.42, 95%CI: 0.13-0.71), respectively. Regarding survival analysis, the pooled mPFS and mOS were 3.81 and 10.15 months. Subgroup analysis showed that pembrolizumab in combination was more beneficial in CR (0.16 vs. 0.03, p = 0.012), PR (0.24 vs. 0.08, p = 0.032), SD (0.11 vs. 0.19, p = 0.043), ORR (0.42 vs. 0.11, p = 0.014), and mPFS (5.54 months vs. 2.27 months, p < 0.001) than as single agent. The three most common AEs were diarrhoea (0.25), anaemia (0.25), and nausea (0.21), and the incidence of grade 3-5 AEs was significantly lower, rarely surpassing 0.10.
Conclusions: For patients with advanced or recurrent cervical cancer, this systematic review and meta-analysis demonstrated that pembrolizumab had a favourable efficacy and tolerability. Future research will primarily focus on optimising customised regiments that optimally integrate pembrolizumab into new therapies and combination strategies. Designed to maximise patient benefit and efficiently control adverse effects while maintaining a high standard of living.
期刊介绍:
Journal of Obstetrics and Gynaecology represents an established forum for the entire field of obstetrics and gynaecology, publishing a broad range of original, peer-reviewed papers, from scientific and clinical research to reviews relevant to practice. It also includes occasional supplements on clinical symposia. The journal is read widely by trainees in our specialty and we acknowledge a major role in education in Obstetrics and Gynaecology. Past and present editors have recognized the difficulties that junior doctors encounter in achieving their first publications and spend time advising authors during their initial attempts at submission. The journal continues to attract a world-wide readership thanks to the emphasis on practical applicability and its excellent record of drawing on an international base of authors.