%0 Journal Article
%T PD-1/PD-L1抑制剂对比化疗一线治疗晚期非小细胞肺癌的Meta分析
%A 张莉
%A 魏瑜
%J 肿瘤防治研究
%D 2019
%R 10.3971/j.issn.1000-8578.2019.18.1190
%X 摘要 目的 系统评价PD-1/PD-L1抑制剂对比化疗一线治疗晚期非小细胞肺癌的疗效及安全性。方法 通过Web of science等国内外数据库，ASCO会议摘要及杂志筛选文献，进行Meta分析。结果 纳入7项RCT研究，4 101例患者，荟萃分析显示抑制剂联合化疗对比化疗可显著延长患者的PFS（HR=0.59, 95%CI: 0.50~0.70, P<0.00001）、OS（HR=0.65, 95%CI: 0.46~0.92, P=0.02）及ORR（RR=1.72, 95%CI: 1.13~2.62, P=0.01）。亚组分析显示，抑制剂联合化疗可显著延长PFS及OS，且PD-L1表达程度越高，疗效获益越显著。而单药抑制剂对比化疗在延长晚期NSCLC患者的PFS（HR=0.87, 95%CI: 0.57~1.31, P=0.50）、OS（HR=0.82, 95%CI: 0.65~1.03, P=0.09）及提高ORR（RR=1.12, 95%CI: 0.55~2.28, P=0.76）方面两组差异无统计学意义。与化疗相比，单药抑制剂一线治疗PD-L1高表达的晚期NSCLC患者可显著延长OS，但在延长PFS方面未见明显优势。与化疗组相比，抑制剂联合化疗组3~4级不良反应发生率无明显改善（HR=1.09，95%CI: 0.99~1.20, P=0.09），而单药PD-1/PD-L1抑制剂组3~4级不良反应发生率低（RR=0.43, 95%CI: 0.36~0.52, P<0.00001）。 结论 PD-1/PD-L1抑制剂联合化疗一线治疗晚期NSCLC患者疗效优于化疗方案；PD-L1高表达者单药PD-1/PD-L1抑制剂可作为一线治疗的优先选择，且具有良好的安全性
%K A Meta-analysis
%K Meta-analysis of Efficacy and Safety of Jinlong Capsule Combined with Chemoradiotherapy on Liver Metastases
%K Therapeutic Effect of Elemene Combined with Chemoradiotherapy and Its Influence on Immune Function in Nasopharyngeal Carcinoma Patients
%K Comparison of Efficacy Between S-1 and Capecitabine/Fluorouracil on Advanced Colorectal Cancer: A Meta-analysis
%K Adverse Reaction of HIPEC Combined with Intravenous Chemotherapy on Ovarian Cancer Patients
%K Prognostic and Clinicopathological Significance of PD-L1 Expression for Colorectal Cancer: A Meta-analysis
%K Value of 18F-FDG PET/CT in Evaluating Chemotherapeutic Effect of Diffuse Large B Cell Lymphoma Patients with Different CD5 Expression
%K Comparison of Survival and Postoperative Complication of Stage Ⅰb2-Ⅱa2 Cervical Cancer Patients Among Three Kinds of Therapeutic Regimens
%K Correlation Between Coke Oven Emissions and Death of Occupational Lung Cancer: A Meta-analysis
%K Progress on Comprehensive Treatment of Nasopharyngeal Cancer
%K Short-term Efficacy and Safety of HepaSphere Drug-loaded Microsphere Embolization on Primary Hepatocellular Carcinoma
%K Clinical Characteristics and Prognosis of Primary Thyroid Lymphoma Patients
%K Prognostic Factors and Comprehensive Treatment of 95 Synovial Sarcoma Patients
%K Prognostic Effects of Different Courses of Neoadjuvant Chemotherapy on Stage N2-3 Locally Advanced Nasopharyngeal Carcinoma
%K Prognosis of Poorly-differentiated Gastric Neuroendocrine Neoplasm
%U http://www.zlfzyj.com/CN/abstract/abstract9397.shtml