卡度尼利单抗治疗恶性实体肿瘤有效性和安全性的Meta分析
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篇名: 卡度尼利单抗治疗恶性实体肿瘤有效性和安全性的Meta分析
TITLE: Efficacy and safety of cadonilimab in the treatment of malignant solid tumors:a meta-analysis
摘要: 目的 系统评价卡度尼利单抗治疗恶性实体瘤患者的有效性和安全性。方法全面检索PubMed、Embase、CochraneLibrary、WebofScience、中国知网、万方、维普和中国生物医学文献数据库,时限为建库至2025年8月。文献筛选严格遵循既定的纳入与排除标准,并通过Cochrane偏倚风险评估工具和MINORS量表分别对随机对照试验和单臂研究进行文献质量评价,使用RevMan和Stata软件进行Meta分析。结果共纳入23项研究(2项随机对照试验、21项单臂研究),涉及2539例患者。随机对照试验合并分析显示,试验组的客观缓解率(ORR)显著优于对照组(RR=1.24,95%CI:1.08~1.42;P=0.002),但任意级别免疫相关不良事件(irAEs)的发生风险也显著更高(RR=5.36,95%CI:3.88~7.42;P<0.00001)。单臂研究合并分析结果显示,卡度尼利单抗的ORR为39.8%(95%CI:31.0%~49.7%),中位无进展生存期为6.39个月(95%CI:4.11~8.67)。亚组分析显示,宫颈癌和胃或胃食管连接处癌患者的ORR分别为54.5%(95%CI:40.8%~67.6%)和54.1%(95%CI:45.1%~62.7%)。安全性方面,≥3级治疗相关不良事件发生率为41.0%(95%CI:31.0%~51.0%),≥3级irAEs发生率为9.9%(95%CI:7.4%~13.8%)。结论卡度尼利单抗在多种实体瘤中展现出显著的疗效优势,且安全性可控,尤其在宫颈癌和胃或胃食管连接处癌中具有重要临床价值。
ABSTRACT: OBJECTIVE To systematically evaluate the efficacy and safety of cadonilimab in patients with malignant solid tumors. METHODS The related literature was comprehensively searched from PubMed, Embase, Cochrane Library, Web of Science, CNKI, Wanfang, VIP, and CBM databases, and the search time ranged from the establishment date to August 2025. Literature screening was strictly adhered to predefined inclusion and exclusion criteria, the quality of randomized controlled trials and single-arm studies were evaluated using the Cochrane risk of bias assessment tool and the MINORS scale, respectively. Meta- analysis was conducted using RevMan and Stata software. RESULTS A total of 23 studies (2 randomized controlled trials, 21 single-arm studies) with 2 539 patients were included. Pooled analysis of RCTs showed that the objective response rate (ORR) was significantly higher in the trial group than in the control group (RR=1.24, 95%CI:1.08-1.42; P=0.002), but the risk of any-grade immune-related adverse events (irAEs) was also significantly increased (RR=5.36, 95%CI:3.88-7.42; P<0.000 01). Pooled analysis of single-arm studies showed that the ORR of cadonilimab was 39.8% (95%CI:31.0%-49.7%), and the median progression free survival was 6.39 months (95%CI:4.11-8.67). Subgroup analysis indicated that the ORR for patients with cervical cancer and gastric or gastroesophageal junction adenocarcinoma were 54.5% (95%CI:40.8%-67.6%) and 54.1% (95%CI: 45.1%-62.7%), respectively. In terms of safety, the incidences of grade ≥3 treatment-related adverse events and irAEs were 41.0% (95%CI: 31.0%-51.0%) and 9.9% (95%CI: 7.4%-13.8%), respectively. CONCLUSIONS Cadonilimab demonstrates significant efficacy advantages in multiple solid tumors, with manageable safety, holding particularly important clinical value in cervical cancer and gastric or gastroesophageal junction adenocarcinoma.
期刊: 2025年第36卷第24期
作者: 黄佩文;李月月;汪龙;王旭东
AUTHORS: HUANG Peiwen,LI Yueyue,WANG Long,WANG Xudong
关键字: 卡度尼利单抗;程序性细胞死亡受体1;细胞毒性T淋巴细胞相关抗原4;双特异性抗体;实体瘤;Meta分析
KEYWORDS: cadonilimab; programmed cell death-1;
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