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胶质母细胞瘤的个体化治疗方法:一项系统综述

英文原题:Personalised therapeutic approaches to glioblastoma: A systematic review.

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Personalised therapeutic approaches to glioblastoma: A systematic review.

PubMed 2023/04/14(内容时间) Front Med (Lausanne) Q1 · IF 3.6(JCR 2025)

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研究概要

个体化胶质母细胞瘤治疗在生存获益方面仍未经证实。证据不一致,且存在高偏倚风险。尽管如此,一些试验中令人鼓舞的结果提供了乐观的理由。未来的重点应针对靶点富集试验、联合治疗、纵向生物标志物监测和标准化报告。

研究思路结论见上方概要

胶质母细胞瘤是最常见且恶性程度最高的原发性脑肿瘤,中位生存期为14.6个月。个性化医疗旨在通过针对患者个体化特征来改善生存。然而,一个主要限制是靶向治疗以非个性化方式应用,而未进行生物标志物富集。这导致疗法存在在没有公平和严格评估的情况下被否定的风险。因此,目的是综合当前关于个性化治疗在胶质母细胞瘤中生存疗效的证据。

报告成人幕上胶质母细胞瘤生存结局的研究符合纳入标准。遵循PRISMA指南。检索了MEDLINE、Embase、Scopus、Web of Science和Cochrane Library至2022年5月5日。检索了ClinicalTrials.gov至2022年5月25日。手工检索了参考文献列表。进行了重复的标题/摘要筛选、数据提取和偏倚风险评估。呈现了定量综合结果。

共纳入102项试验:其中16项为随机试验,41项研究新诊断患者。在5,527例纳入患者中,59.4%为男性,平均年龄为53.7岁。共纳入20余种个体化治疗:靶向分子治疗研究最多(33.3%,34/102),其次为自体树突状细胞疫苗(32.4%,33/102)和自体肿瘤疫苗(10.8%,11/102)。尚无一致证据表明任何个体化治疗具有生存疗效。

展开英文摘要原文

Studies reporting a survival outcome in human adults with supratentorial glioblastoma were eligible. PRISMA guidelines were followed. MEDLINE, Embase, Scopus, Web of Science and the Cochrane Library were searched to 5th May 2022. Clinicaltrials.gov was searched to 25th May 2022. Reference lists were hand-searched. Duplicate title/abstract screening, data extraction and risk of bias assessments were conducted. A quantitative synthesis is presented.

A total of 102 trials were included: 16 were randomised and 41 studied newly diagnosed patients. Of 5,527 included patients, 59.4% were male and mean age was 53.7 years. More than 20 types of personalised therapy were included: targeted molecular therapies were the most studied (33.3%, 34/102), followed by autologous dendritic cell vaccines (32.4%, 33/102) and autologous tumour vaccines (10.8%, 11/102). There was no consistent evidence for survival efficacy of any personalised therapy.

Personalised glioblastoma therapies remain of unproven survival benefit. Evidence is inconsistent with high risk of bias. Nonetheless, encouraging results in some trials provide reason for optimism. Future focus should address target-enriched trials, combination therapies, longitudinal biomarker monitoring and standardised reporting.

论文信息

作者
Mowforth OD、Brannigan J、El Khoury M、Sarathi CIP、Bestwick H、Bhatti F、Mair R
单位
Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, England, United Kingdom.United Kingdom
文献类型
系统综述
期刊
Frontiers in medicine2023
原文标识
PubMed 37122327 · DOI 10.3389/fmed.2023.1166104