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Network meta-analysis of first-line treatments for metastatic urothelial carcinoma
- ZHONGGUO YAOFANG Vol. 35, Issue 22, Pages: 2815-2821(2024)
- 作者机构：
河北省人民医院药学部/河北省临床药学重点实验室，石家庄 050051
- 作者简介：
- 基金信息：
DOI：10.6039/j.issn.1001-0408.2024.22.19
CLC： R969.1;R969.3Published：30 November 2024，
Received：19 March 2024，
Revised：28 July 2024，
- 稿件说明：
移动端阅览
邱学佳,任炳楠,方灵芝等.转移性尿路上皮癌一线治疗方案的网状Meta分析 Δ[J].中国药房,2024,35(22):2815-2821.
QIU Xuejia,REN Bingnan,FANG Lingzhi,et al.Network meta-analysis of first-line treatments for metastatic urothelial carcinoma[J].ZHONGGUO YAOFANG,2024,35(22):2815-2821.
邱学佳,任炳楠,方灵芝等.转移性尿路上皮癌一线治疗方案的网状Meta分析 Δ[J].中国药房,2024,35(22):2815-2821. DOI： 10.6039/j.issn.1001-0408.2024.22.19.
QIU Xuejia,REN Bingnan,FANG Lingzhi,et al.Network meta-analysis of first-line treatments for metastatic urothelial carcinoma[J].ZHONGGUO YAOFANG,2024,35(22):2815-2821. DOI： 10.6039/j.issn.1001-0408.2024.22.19.
摘要
目的
2
采用网状Meta分析方法系统评价不同治疗方案用于转移性尿路上皮癌一线治疗的有效性。
方法
2
计算机检索PubMed、the Cochrane Library、Embase、万方数据、中国知网和维普网，检索用于转移性尿路上皮癌一线治疗的随机对照临床试验（RCTs），检索时限自2010年1月1日至2024年1月31日。筛选文献、提取资料后，对纳入研究进行风险偏倚评价。采用R 4.3.2软件进行网状Meta分析。
结果
2
共纳入了11项RCTs，包括14种治疗措施。在客观缓解率方面，各组间差异无统计学意义，帕博利珠单抗联合吉西他滨及顺铂方案排第一的概率最大。在无进展生存期（PFS）和总生存期（OS）方面，各组间差异无统计学意义，维恩妥尤单抗联合帕博利珠单抗在延长PFS方面有优于吉西他滨联合顺铂方案的趋势[HR＝0.45，95%CI（0.20，1.06），
P
＝0.049
]
，且其在PFS和OS中排第一的概率均最大。
结论
2
在转移性尿路上皮癌的一线治疗中，维恩妥尤单抗联合帕博利珠单抗可能在延长生存期方面更有优势。
Abstract
OBJECTIVE
2
To systematically evaluate the effectiveness of different treatment regimens as first-line treatment for metastatic urothelial carcinoma （UC） using a network meta-analysis （NMA） approach.
METHODS
2
Electronic databases including PubMed， the Cochrane Library， Embase， Wanfang Data， CNKI， and VIP were searched for randomized controlled clinical trials （RCTs） on first-line treatment for metastatic UC from January 1， 2010 to January 31， 2024. After literature screening and data extraction， a risk of bias assessment of included studies was conducted. R software （version 4.3.2） was used to perform the NMA.
RESULTS
2
A total of 11 RCTs involving 14 treatment interventions were included. No significant differences were noted in objective response rate among groups， with the combination of pembrolizumab， gemcitabine and cisplatin having the highest probability of ranking first. Regarding progression-free survival （PFS） and overall survival （OS）， no significant differences were observed among groups， while enfortumab vedotin combined with pembrolizumab showed a trend towards better PFS extension compared to gemcitabine combined with cisplatin [HR＝0.45， 95%CI（0.20，1.06），
P
＝0.049
]
， and it had the highest probability of ranking first in both PFS and OS.
CONCLUSIONS
2
The combination of enfortumab vedotin and pembrolizumab may have an advantage in prolonging survival in the first-line treatments for metastatic UC.
关键词
转移性尿路上皮癌网状Meta分析帕博利珠单抗维恩妥尤单抗吉西他滨顺铂
Keywords
network meta-analysispembrolizumabenfortumab vedotingemcitabinecisplatin
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