中国药房2025，Vol.36Issue(16)：2067-2072,6.DOI:10.6039/j.issn.1001-0408.2025.16.20
阿帕替尼联合PD-1/PD-L1抑制剂治疗恶性实体瘤有效性与安全性的Meta分析
Meta-analysis of the efficacy and safety of apatinib combined with PD-1/PD-L1 inhibitors in the treatment of malignant solid tumors
摘要
Abstract
OBJECTIVE To evaluate the efficacy and safety of apatinib combined with PD-1/PD-L1 inhibitors in the treatment of malignant solid tumors.METHODS Randomized controlled trials(RCTs)on apatinib combined with PD-1/PD-L1 inhibitors(combination group)versus monotherapy(apatinib or PD-1/PD-L1)combined with(or)chemotherapy/other treatments(control group)in the treatment of malignant solid tumors were collected from PubMed,Web of Science,Embase,Cochrane Library,CNKI,VIP,Wanfang Data and China Biomedical Literature Database.The search time limit was from the establishment of the databases to May 2025.After literature screening,data extraction and literature quality evaluation,meta-analysis was performed using RevMan 5.3 and Stata 14.0.RESULTS A total of 28 RCTs involving 2 974 patients were included.The objective response rate[RR=1.639,95%CI(1.452,1.851),P＜0.000 01],disease control rate[RR=1.284,95%CI(1.178,1.399),P＜0.000 01]and CD3+,CD4+,CD4+/CD8+as well as the incidence of ADR such as hypertension,fatigue,proteinuria,thrombocytopenia were significantly higher in the combination group than control group(P＜0.05 or P＜0.000 01).The progressive disease rate[RR=0.497,95%CI(0.437,0.566),P＜0.000 01]and serum tumor marker levels and CD8+were significantly lower in the combination group than control group(P＜0.05 or P＜0.000 01).Subgroup analysis results of different types of tumors showed that the objective response rate and disease control rate were significantly higher in the combination group than control group(P＜0.05).The results of sensitivity analysis showed that the stability of this study was good.The results of publication bias analysis showed that there was a high possibility of publication bias in this study.CONCLUSIONS Apatinib combined with PD-1/PD-L1 inhibitors has a significant efficacy in the treatment of different types of tumors,but attention should be paid to the occurrence of hypertension,fatigue,proteinuria and thrombocytopenia.关键词
阿帕替尼/PD-1抑制剂/PD-L1抑制剂/恶性实体瘤/Meta分析Key words
apatinib/PD-1 inhibitor/PD-L1 inhibitor/malignant solid tumors/meta-analysis分类
医药卫生引用本文复制引用
王辰,李君,王宁,于新娟,于晓露,李廷天..阿帕替尼联合PD-1/PD-L1抑制剂治疗恶性实体瘤有效性与安全性的Meta分析[J].中国药房,2025,36(16):2067-2072,6.基金项目
山东省医药卫生科技发展计划(No.202203020181) （No.202203020181）
青岛市医药卫生科研指导项目(No.2023-WJZD177) （No.2023-WJZD177）
