Efficacy and toxicity profile of first-line treatment for extensive-stage small cell lung cancer: A Bayesian network meta-analysis

被引:3
|
作者
Lin, Guo [1 ,2 ]
Yao, Zhuoran [1 ,2 ]
Kang, Kai [1 ,2 ]
Wang, Hui [1 ,2 ]
Luo, Ren [1 ,2 ]
Lu, You [1 ,2 ,3 ,4 ]
机构
[1] Sichuan Univ, West China Hosp, Thorac Oncol Ward, Canc Ctr, Chengdu, Sichuan, Peoples R China
[2] Sichuan Univ, West China Hosp, Lab Clin Cell Therapy, Chengdu, Sichuan, Peoples R China
[3] Sichuan Univ, West China Hosp, Thorac Oncol Ward, Canc Ctr, Chengdu 610041, Sichuan, Peoples R China
[4] Sichuan Univ, West China Hosp, Lab Clin Cell Therapy, Chengdu 610041, Sichuan, Peoples R China
来源
CANCER MEDICINE | 2023年 / 12卷 / 09期
基金
中国国家自然科学基金;
关键词
extensive-stage small cell lung cancer; first-line; immunotherapy; network meta-analysis; RANDOMIZED-PHASE-III; IRINOTECAN PLUS CARBOPLATIN; ADVERSE EVENTS; OPEN-LABEL; ETOPOSIDE; CHEMOTHERAPY; TRIAL; MULTICENTER; COMBINATION; SAFETY;
D O I
10.1002/cam4.5750
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background: The efficacy and toxicity profiles for extensive-stage small cell lung cancer (ES-SCLC) are unclear. We aimed to address this gap through a Bayesian network meta-analysis. Methods: We performed network analysis from randomized controlled trials comparing these treatments: PD-(L)1 inhibitor, CTLA-4 inhibitor, CXCR inhibitor, PARP inhibitor, CDK inhibitor, chemotherapy, and their combinations. Pooled estimations of progression-free survival, overall survival, objective response rate, and toxicity (systematic and specific) were conducted within the Bayesian framework. Results: Twenty-five trials involving 9 strategies were included. In terms of progression-free survival and overall survival, PD-(L)1 inhibitor combined with cisplatin/carboplatin (P) and etoposide (E) shown the acknowledged superiority than other treatments. The addition of CTLA-4 inhibitor (ipilimumab) to EP had the highest response rate among these regimens, and the combination of chemotherapy (irinotecan) and cisplatin/carboplatin had the greatest probability of performing considerable systematic security. The secondary endpoint was specific adverse events, including vomiting, fatigue, thrombocytopenia, constipation, and decreased appetite; hence we depicted the specific toxicity profile of each regimen. In addition, we identified the differences between PD-1 inhibitors and PD-L1 inhibitors in prolonging overall survival time for the central nervous system (CNS)/liver metastases patients. Conclusions: EP combined with PD-(L)1 inhibitor followed by CTLA-4 inhibitors or anti-angiogenesis was the considerable treatment with considerable efficacy and safety for ES-SCLC. Each treatment has a unique specific toxicity profile, which needs more attention.
引用
收藏
页码:10230 / 10242
页数:13
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