昆明医科大学学报2024，Vol.45Issue(6)：75-84,10.DOI:10.12259/j.issn.2095-610X.S20240610
卡瑞利珠联合化疗治疗非小细胞肺癌的有效性及安全性Meta分析
A Meta-analysis of the Efficacy and Safety of Camrelizumab Combined with Chemotherapy in the Treatment of Non-small Cell Lung Cancer
摘要
Abstract
Objective To discuss the difference in efficacy and safety of immune checkpoint inhibitor camrelizumab alone and combined chemotherapy in the treatment of non-small cell lung cancer.Aggregate analysis of multiple clinical trial data was conducted to obtain more accurate efficacy and safety evaluation,and bring effective information and medication guidance to clinical patients.Methods By searching PubMed,Embase,Cochrane Library,CBM database,CNKI,VIP Chinese database and Wanfang database,we collected the required randomized controlled trials or non-randomized controlled trials published until November 30,2023.After data extraction,Revman5.4 software was applied for data analysis.According to the different treatment plan,the study subjects were divided into camrelizumab combined chemotherapy group and chemotherapy group alone for research discussion.Results A total of 19 articles were included,with a total of 1545 patients.Meta results showed:compared with chemotherapy alone,camrelizumab combined with chemotherapy in the treatment of non-small lung cancer was more effective in improving the overall response rate(OR=2.50,95%CI:2.02～3.08,P<0.00001),increased the CD4+/CD8+ratio(MD=0.26,95%CI:0.19～0.33,P<0.00001)and effectively reduced the serum tumor marker CA125(MD=-10.65,95%CI:-14.34～-6.96,P<0.00001)and CEA(MD=5.56,95%CI:-7.64～-3.47,P<0.00001),CY211(MD=-2.17,95%CI:-3.22～1.13,P=0.00001).Different adverse reactions showed different cluster analysis results.Among them,camrelizumab combined chemotherapy increased anemia(OR=1.95,95%CI:1.09～3.51,P=0.03),hypothyroidism(OR=5.61,95%CI:1.82～17.25,P=0.003)and capillary hyperplasia(OR=2.86,95%CI:1.19～6.88,P=0.02)compared with chemotherapy alone,P values were all<0.05,and the difference was statistically significant.However,rash(OR=1.34,95%CI:0.82～2.16,P=0.24),myelosuppression(OR=1.06,95%CI:0.56～2.02,P=0.86),leukopenia(OR=0.78,95%CI:0.40～1.52,P=0.47),alopecia(OR=1.29,95%CI:0.57～2.92,P=0.54),neurological abnormalities(OR=1.17,95%CI:0.39～3.56,P=0.78),digestive tract abnormalities(OR=1.10,95%CI:0.79～1.53,P=0.57),liver function abnormalities(OR=1.54,95%CI:0.92～2.59,P=0.10),nausea and vomiting(OR=1.16,95%CI:0.58～2.31,P=0.67),coughing up blood(OR=0.87,95%CI:0.30～2.49,P=0.79),fever(OR=1.22,95%CI:0.65～2.30,P=0.54)and others(OR=1.32,95%CI:0.76～2.31,P=0.32)had no significant change in the incidence of symptoms,and all P values were greater than 0.05,the difference was not statistically significant.Taking into account the incidence of all kinds of adverse reactions mentioned above,in general,camrelizumab combined chemotherapy did not increase the incidence of adverse reactions compared with chemotherapy alone(OR=1.32,95%CI:1.13～1.55,P=0.23),with a P value greater than 0.05,and the difference was not statistically significant.Conclusion Compared with chemotherapy alone,camrelizumab combined chemotherapy can more effectively improve the overall response rate and CD4+/CD8+ratio in patients with non-small cell lung cancer,reduce the absolute value of serum tumor markers,and does not increase the incidence of adverse reactions,with good safety.关键词
卡瑞利珠/非小细胞肺癌/联合治疗/化疗/Meta分析/PD-1抑制剂Key words
Camrelizumab/Non-small cell lung cancer/Combination therapy/Chemotherapy/Meta-analysis/PD-1 inhibitors分类
医药卫生引用本文复制引用
张彩妮,李娅..卡瑞利珠联合化疗治疗非小细胞肺癌的有效性及安全性Meta分析[J].昆明医科大学学报,2024,45(6):75-84,10.基金项目
国家自然科学基金资助项目(82160696,82160407) （82160696,82160407）
云南省科技厅-昆明医科大学应用基础联合专项基金资助项目(202401AY070001-033) （202401AY070001-033）
云南省/昆医大附一院重大科技专项基金资助项目(2023zdpy05) （2023zdpy05）
