摘要
目的采用网状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。
OBJECTIVE 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 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 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 The combination of enfortumab vedotin and pembrolizumab may have an advantage in prolonging survival in the first-line treatments for metastatic UC.
作者
邱学佳
任炳楠
方灵芝
连玉菲
吴玉佩
董占军
QIU Xuejia;REN Bingnan;FANG Lingzhi;LIAN Yufei;WU Yupei;DONG Zhanjun(Department of Pharmacy,Hebei General Hospital/Hebei Key Laboratory of Clinical Pharmacy,Shijiazhuang 050051,China)
出处
《中国药房》
CAS
北大核心
2024年第22期2815-2821,共7页
China Pharmacy
基金
河北省医学科学研究课题计划(No.20211586)。
