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1.首都医科大学附属北京友谊医院药学部,北京 100050
2.应急总医院药学部,北京 100028
3.首都医科大学护理学院,北京 100069
药师。研究方向:肿瘤药学。E-mail:13810994929@139.com
主任药师,博士。研究方向:肿瘤药学。E-mail:junxianyu@ccmu.edu.cn
纸质出版日期:2023-12-30,
收稿日期:2023-05-08,
修回日期:2023-11-21,
扫 描 看 全 文
廖雯,陈威,陈嘉怡等.免疫检查点抑制剂用于KRAS基因不同分型NSCLC疗效的Meta分析[J].中国药房,2023,34(24):3055-3059.
LIAO Wen,CHEN Wei,CHEN Jiayi,et al.Meta-analysis of the efficacy of immune checkpoint inhibitors in the treatment of NSCLC with different KRAS genotypes[J].ZHONGGUO YAOFANG,2023,34(24):3055-3059.
廖雯,陈威,陈嘉怡等.免疫检查点抑制剂用于KRAS基因不同分型NSCLC疗效的Meta分析[J].中国药房,2023,34(24):3055-3059. DOI: 10.6039/j.issn.1001-0408.2023.24.18.
LIAO Wen,CHEN Wei,CHEN Jiayi,et al.Meta-analysis of the efficacy of immune checkpoint inhibitors in the treatment of NSCLC with different KRAS genotypes[J].ZHONGGUO YAOFANG,2023,34(24):3055-3059. DOI: 10.6039/j.issn.1001-0408.2023.24.18.
目的
2
评价免疫检查点抑制剂(ICIs)用于鼠类肉瘤病毒癌基因(
KRAS
)基因不同分型非小细胞肺癌(NSCLC)的疗效。
方法
2
计算机检索PubMed、the Cochrane Library、Web of Science、Embase、中国知网、万方数据、维普网,收集ICIs单药或多种ICIs联用或ICIs联合传统化疗(试验组)对比传统化疗(对照组)用于NSCLC的随机对照试验(RCTs),检索时限为建库至2023年4月1日。筛选文献、提取数据和评价质量后,采用RevMan 5.4软件进行Meta分析、敏感性分析和发表偏倚分析。
结果
2
共纳入7项RCTs,合计5 980例患者。Meta分析结果显示,试验组患者的总生存期(OS)[HR=0.79,95%CI(0.72,0.87),
P
<0.000 01]、无进展生存期(PFS)[HR=0.63,95%CI(0.50,0.80),
P
=0.000 2]均显著长于对照组,且试验组
KRAS
突变型[HR=0.63,95%CI(0.53,0.75),
P
<0.000 01]、
KRAS
野生型[HR=0.87,95%CI(0.78,0.98),
P
=0.02]患者的OS,
KRAS
突变型[HR=0.58,95%CI(0.43,0.78),
P
=0.000 3]、
KRAS
野生型[HR=0.68,95%CI(0.47,0.99),
P
=0.04]患者的PFS均显著长于对照组;按不同治疗方案进行亚组分析的结果显示,试验组使用一、二线治疗方案,单用ICIs,使用ICIs联合传统化疗的
KRAS
突变型患者的OS,以及试验组使用一线治疗方案的
KRAS
突变型、
KRAS
野生型患者的PFS均显著长于对照组(
P
<0.05)。敏感性分析结果显示,本研究所得结果较稳健。发表偏倚结果显示,本研究存在发表偏倚的可能性较小。
结论
2
ICIs用于NSCLC患者的疗效显著,且无论是否发生
KRAS
突变,NSCLC患者都同样受益。
OBJECTIVE
2
To evaluate the efficacy of immune checkpoint inhibitors (ICIs) in the treatment of non-small cell lung cancer (NSCLC) with different
KRAS
genotypes.
METHODS
2
Retrieved from PubMed, the Cochrane Library, Web of Science, Embase, CNKI, Wanfang data and VIP, randomized controlled trials (RCTs) about ICIs alone, combined use of various ICIs or ICIs combined with traditional chemotherapy (trial group) versus traditional chemotherapy (control group) for NSCLC were collected from the inception of the databases to April 1, 2023. After screening literature, extracting data and evaluating quality, meta-analysis, sensitivity analysis and publication bias analysis were conducted by using RevMan 5.4 software.
RESULTS
2
A total of 7 RCTs involving 5 980 patients were included. The results of the meta-analysis showed that overall survival (OS) [HR=0.79, 95%CI (0.72, 0.87),
P
<0.000 01] and progression-free survival (PFS) [HR=0.63, 95%CI (0.50, 0.80),
P
=0.000 2] of trial group were significantly longer than those of control group; furthermore, the OS of
KRAS
mutant type [HR=0.63, 95%CI (0.53, 0.75),
P
<0.000 01] and
KRAS
wild type [HR=0.87, 95%CI (0.78, 0.98),
P
=0.02], PFS of
KRAS
mutant type [HR=0.58, 95%CI (0.43, 0.78),
P
=0.000 3] and
KRAS
wild type [HR=0.68, 95%CI (0.47, 0.99),
P
=0.04] in the trial group were all significantly longer than in the control group. Subgroup analysis by different treatment regimens showed that the OS of
KRAS
mutant type patients receiving first- and second-line treatment regimens, using ICIs alone and those receiving ICIs combined with traditional chemotherapy as well as PFS of
KRAS
mutant type and wild type patients receiving first-line treatment regimens in the trial group were all significantly longer than in the control group (
P
<0.05). Sensitivity analysis results indicated that the findings of this study were robust. Publication bias results showed that the possibility of publication bias in this study was small.
CONCLUSIONS
2
ICIs show significant efficacy in NSCLC patients, and NSCLC patients benefit equally regardless of whether
KRAS
mutations occur.
免疫检查点抑制剂非小细胞肺癌鼠类肉瘤病毒癌基因疗效
non-small cell lung cancerKRASefficacy
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