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固有免疫和适应性免疫治疗联合标准治疗用于高级别胶质瘤的疗效与安全性：一项系统评价和 meta 分析

英文原题：Efficacy and safety of innate and adaptive immunotherapy combined with standard of care in high-grade gliomas: a systematic review and meta-analysis.

查看英文原题

Efficacy and safety of innate and adaptive immunotherapy combined with standard of care in high-grade gliomas: a systematic review and meta-analysis.

PubMed 2023/07/06（内容时间） Front Immunol Q1 · IF 7（JCR 2025）

分数与星级只用于站内排序 —— 不代表疗效、安全性或个人适用性。

技术：树突状细胞疫苗技术：溶瘤病毒胶质瘤地区：中国
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研究概要

因此，DC 疫苗显著延长了 HGG 患者的 OS，但 VT 和 IP 的疗效仍需进一步研究探索。所评估的所有治疗方案均与某些副作用相关。

研究思路结论见上方概要

背景

恶性胶质瘤是最常见的颅内恶性肿瘤，死亡率最高。在免疫治疗时代，确定哪种类型的免疫治疗能提供最佳的生存机会非常重要。

方法

在此，通过系统评价和meta分析评估了免疫治疗在高级别胶质瘤（HGG）中的疗效和安全性。探讨了不同类型免疫治疗之间的差异。检索到的命中结果在2,317篇文章中筛选纳入。我们提取了总生存期（OS）和无进展生存期（PFS）的风险比（HR）作为检验免疫治疗疗效的两个关键结局。我们还分析了所报告相应不良事件的数据，以评估免疫治疗的安全性。本研究已在PROSPERO注册（CRD42019112356）。

结果

我们共纳入1,271例患者，其中524例接受了免疫治疗联合标准治疗（SOC），747例仅接受SOC。我们发现免疫治疗延长了OS（HR = 0.74；95% CI，0.56-0.99；Z = -2.00，P = 0.0458 < 0.05）和PFS（HR = 0.67；95% CI，0.45-0.99；Z = -1.99，P = 0.0466 < 0.05），尽管出现了一些不良事件（比例 = 0.0773，95% CI，0.0589-0.1014）。我们的数据证明了树突状细胞（DC）疫苗在延长胶质瘤患者OS方面的疗效（HR = 0.38；95% CI，0.21-0.68；Z = -3.23；P = 0.0012 < 0.05）。溶瘤病毒治疗（VT）仅在亚组分析中延长了患者生存期（HR = 0.60；95% CI，0.45-0.80；Z = -3.53；P = 0.0004 < 0.05）。相比之下，免疫增强（IP）未延长OS（HR = 0.69；95% CI，0.50-0.96；Z = -2.23；P = 0.0256）。

展开英文摘要原文
BACKGROUND

Malignant glioma is the most common intracranial malignant tumor with the highest mortality. In the era of immunotherapy, it is important to determine what type of immunotherapy provides the best chance of survival. METHOD: Here, the efficacy and safety of immunotherapy in high-grade glioma (HGG) were evaluated by systematic review and meta-analysis. The differences between various types of immunotherapy were explored. Retrieved hits were screened for inclusion in 2,317 articles. We extracted the overall survival (OS) and progression-free survival (PFS) hazard ratios (HRs) as two key outcomes for examining the efficacy of immunotherapy. We also analyzed data on the reported corresponding adverse events to assess the safety of immunotherapy. This study was registered with PROSPERO (CRD42019112356).

RESULTS

We included a total of 1,271 patients, of which 524 received a combination of immunotherapy and standard of care (SOC), while 747 received SOC alone. We found that immunotherapy extended the OS (HR = 0.74; 95% confidence interval [CI], 0.56-0.99; Z = -2.00, P = 0.0458 < 0.05) and PFS (HR = 0.67; 95% CI, 0.45-0.99; Z = -1.99, P = 0.0466 < 0.05), although certain adverse events occurred (proportion = 0.0773, 95% CI, 0.0589-0.1014). Our data have demonstrated the efficacy of the dendritic cell (DC) vaccine in prolonging the OS (HR = 0.38; 95% CI, 0.21-0.68; Z = -3.23; P = 0.0012 < 0.05) of glioma patients. Oncolytic viral therapy (VT) only extended patient survival in a subgroup analysis (HR = 0.60; 95% CI, 0.45-0.80; Z = -3.53; P = 0.0004 < 0.05). By contrast, immunopotentiation (IP) did not prolong OS (HR = 0.69; 95% CI, 0.50-0.96; Z = -2.23; P = 0.0256).

CONCLUSION

Thus, DC vaccination significantly prolonged the OS of HGG patients, however, the efficacy of VT and IP should be explored in further studies. All the therapeutic schemes evaluated were associated with certain side effects. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=112356.

论文信息

作者
Guo B、Zhang S、Xu L、Sun J、Chan WL、Zheng P、Zhang J、Zhang L
第一作者单位
Department of Plastic Surgery, China-Japan Union Hospital of Jilin University, Changchun, China.China
通讯作者单位
Department of Pathophysiology, College of Basic Medical Sciences of Jilin University, Changchun, Jilin, China.China
文献类型
荟萃分析 · 系统综述 · 非美国政府资助研究
期刊
Frontiers in immunology2023
原文标识
PubMed 37483593　·　DOI 10.3389/fimmu.2023.966696

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