Effects of Clinicopathological Characteristics on the Survival of Patients Treated with PD-1/PD-L1 Inhibitor Monotherapy or Combination Therapy for Advanced Cancer: A Systemic Review and Meta-Analysis
Autor: | Hong Guo, Xinyi Peng, Qin Li, Yongyan Li, Qi Du, Yongfu Li, Jiangtao Jin, Yuhan Wei |
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Jazyk: | angličtina |
Rok vydání: | 2020 |
Předmět: |
0301 basic medicine
Oncology medicine.medical_specialty Combination therapy medicine.medical_treatment Immunology Programmed Cell Death 1 Receptor Review Article medicine.disease_cause B7-H1 Antigen Metastasis law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Internal medicine Neoplasms Antineoplastic Combined Chemotherapy Protocols medicine Immunology and Allergy Humans Immune Checkpoint Inhibitors Neoplasm Staging Proportional Hazards Models business.industry Hazard ratio Cancer General Medicine Immunotherapy RC581-607 medicine.disease Prognosis 030104 developmental biology Treatment Outcome 030220 oncology & carcinogenesis Meta-analysis KRAS Immunologic diseases. Allergy Neoplasm Grading business |
Zdroj: | Journal of Immunology Research Journal of Immunology Research, Vol 2020 (2020) |
ISSN: | 2314-7156 2314-8861 |
Popis: | Background. PD-1/PD-L1 inhibitors have made unprecedented progress in the treatment of cancer. Methods. A systemic search was conducted for randomized controlled trials that compared PD-1/PD-L1 inhibitor monotherapy or combination therapy with nonimmunotherapy. Hazard ratios (HRs) of overall survival (OS) according to the sex, age, ECOG PS, smoking status, liver metastasis, PD-L1 expression, EGFR, and KRAS status of patients were analyzed. Results. Totally, 13 studies with monotherapy and 5 with combination regimens were included, and the pooled HRs of OS were 0.74 ( P < 0.001 ) and 0.64 ( P < 0.001 ), respectively. EGFR wild-type patients could benefit from immunotherapy monotherapy (HR, 0.77; P < 0.001 ) while those of the mutant type had no survival benefit (HR, 1.11; P = 0.54 ), and the difference was statistically significant (interaction, P = 0.005 ). KRAS wild-type patients had no survival benefit from monotherapy (HR, 0.89; P = 0.49 ). For combination therapy, both male and female derived benefits but female had a significantly reduced risk of death (HR, 0.45; P < 0.001 ) compared with male (HR, 0.73; P < 0.001 ; interaction, P = 0.004 ). Nonsmokers derived more survival benefits from combination therapy (HR, 0.29; P < 0.001 ) than smokers (HR, 0.63; P = 0.001 ; interaction, P = 0.02 ). No significant difference was found between age, ECOG PS, liver metastasis, PD-L1 expression, and OS of both PD-1/PD-L1 inhibitor monotherapy and combination therapy. Conclusions. Both PD-1/PD-L1 inhibitor monotherapy and combination therapy significantly prolonged the OS of patients with advanced malignant tumors. EGFR status for monotherapy and sex and smoking status for combination therapy were important predictors of survival benefits. |
Databáze: | OpenAIRE |
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