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替莫唑胺联合免疫治疗用于胶质母细胞瘤的系统综述

英文原题:A systematic review of immunotherapies in combination with temozolomide as treatment for glioblastoma.

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A systematic review of immunotherapies in combination with temozolomide as treatment for glioblastoma.

PubMed 2025/02/24(内容时间) Cancer Treat Res Commun Q2 · IF 3.5(JCR 2025)

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中文摘要

胶质母细胞瘤占成人恶性中枢神经系统肿瘤病例的很大比例,患者确诊后通常生存不超过一年。除化疗、放疗和手术外,能显著延长患者生存的治疗选择很少。有许多临床试验正在研究免疫治疗-化疗联合治疗。本系统综述通过数据库检索临床试验,识别评估成人患者中位总生存期和无进展生存期的随机对照免疫治疗-替莫唑胺联合试验。本综述还评估了所选试验的研究设计偏倚风险。预期结局按所选研究报告的内容呈现,并根据报告的统计学显著性进行评估。

我们在最终筛选中纳入10项研究,发现五项研究聚焦于贝伐珠单抗作为免疫治疗与替莫唑胺联合使用,而五项研究使用了独特干预措施。在这些研究中,只有贝伐珠单抗和自体树突状细胞疫苗报告了与对照组相比预期结局的改善。偏倚风险分析仅发现一项研究存在高偏倚风险,五项研究在盲法方面存在不明确的偏倚风险。

我们的研究识别了有前景的治疗方法,并建议进一步审查这些干预措施,但未对当前胶质母细胞瘤治疗的改变提出任何建议。作者声明无资金支持或利益冲突。作者在撰写本综述时遵循了系统综述和荟萃分析优先报告条目指南。

展开英文摘要原文

Glioblastomas comprise a significant percentage of malignant adult central nervous system tumor cases and patients typically do not survive longer than a year after diagnosis. There are few treatment options for patients which meaningfully prolong survival other than chemotherapy, radiotherapy, and surgery. There are many clinical trials examining immunotherapy-chemotherapy combination treatments.

This systematic review uses database research of clinical trials to identify randomized controlled immunotherapy-temozolomide combination trials which evaluate the median overall and progression-free survival in adult patients. The review also assesses the study design of selected trials for risk of bias. The desired outcomes are presented as they are reported in the selected studies and are evaluated based on reported statistical significance.

We included 10 studies in the final selection and found five studies focused on bevacizumab as an immunotherapy in combination with temozolomide while five used unique interventions. Of those studies, only bevacizumab and autologous dendritic cell vaccination reported an improvement in desired outcomes compared to the control. The risk of bias analysis identified only one study with high risk of bias and five studies with unclear risk of bias in blinding.

Our study identifies promising treatments and recommends further examination of those interventions but does not make any recommendations on changes to current glioblastoma treatments. The authors have no funding or conflict of interests to declare. The authors followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines for writing this review.

论文信息

作者
Chen B、Alder J
第一作者单位
Department of Neuroscience, Rutgers Robert Wood Johnson Medical School, 675 Hoes Lane West, Piscataway, NJ 08854, USA. Electronic address: bc723@scarletmail.rutgers.edu.United States
通讯作者单位
Department of Neuroscience, Rutgers Robert Wood Johnson Medical School, 675 Hoes Lane West, Piscataway, NJ 08854, USA. Electronic address: janet.alder@rutgers.edu.United States
文献类型
系统综述
期刊
Cancer treatment and research communications2025
原文标识
PubMed 40023003 · DOI 10.1016/j.ctarc.2025.100888