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抗体偶联药物治疗乳腺癌后致肺炎和间质性肺病的网状Meta分析
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| 篇名： | 抗体偶联药物治疗乳腺癌后致肺炎和间质性肺病的网状Meta分析 |
| TITLE： | Network meta-analysis of pneumonitis and interstitial lung disease associated with antibody-drug conjugates in the treatment of breast cancer |
| 摘要： | 目的 比较不同抗体偶联药物（ADC）治疗乳腺癌后致肺炎和间质性肺病（ILD）的发生风险。方法检索中国知网、维普网、PubMed、Embase等中英文数据库和ClinicalTrials.gov，收集ADC[恩美曲妥珠单抗（T-DM1）、德曲妥珠单抗（T-DXd）、戈沙妥珠单抗（SG）、德达博妥单抗（Dato-DXd）、瑞康曲妥珠单抗（SHR-A1811）、ARX788、T-Duo]治疗乳腺癌后发生肺炎和ILD的随机对照试验（RCT），检索时间为建库至2025年6月15日。筛选文献、提取数据、评价文献质量后，采用Stata17.0软件进行网状Meta分析，并对各干预措施的累积排序曲线下面积（SUCRA）进行排序。结果共纳入19项RCT，共计10556例患者。ARX788、T-DXd的总体肺炎发生率显著高于T-DM1、T-DM1plusTPC（T-DM1联合帕妥珠单抗或阿替利珠单抗）、TPC（常规治疗）和SG（P＜0.05），ARX788、T-DXd的1～2级肺炎发生率显著高于T-DM1、T-DM1plusTPC和TPC（P＜0.05），上述2个指标SUCRA排序前2位的均为ARX788、T-Duo。T-DXd、T-DM1的≥3级肺炎发生率显著高于SG（P＜0.05），SUCRA排序前2位的为T-Duo、Dato-DXd。ARX788的总体ILD发生率显著高于T-DM1、SHR-A1811、TPC和SG（P＜0.05），1～2级ILD发生率显著高于T-DM1、SHR-A1811和TPC（P＜0.05），≥3级ILD发生率显著高于TPC（P＜0.05），上述3个指标SUCRA排序前2位的均为ARX788、T-DXd联合帕妥珠单抗。结论相比于其他ADC，ARX788和T-Duo治疗乳腺癌后患者的肺炎和ILD发生风险较高。 |
| ABSTRACT： | OBJECTIVE To compare the risk of pneumonitis and interstitial lung disease （ILD） associated with different antibody-drug conjugates （ADC） in the treatment of breast cancer. METHODS CNKI， VIP， PubMed， Embase and other Chinese and English databases， and ClinicalTrials.gov were searched from the inception to June 15， 2025. Randomized controlled trials （RCT） about pneumonitis and ILD associated with ADC （T-DM1， T-DXd， SG， Dato-DXd， SHR-A1811，ARX788， and T-Duo） in the treatment of breast cancer were included. After literature screening， data extraction， and quality assessment， a network meta-analysis was conducted using Stata 17.0 software， and the surface under the cumulative ranking curve（SUCRA） of all interventions were ranked. RESULTS A total of 19 RCTs involving 10 556 patients were included. The overall incidence of pneumonitis with ARX788 and T-DXd was significantly higher than that with T-DM1， T-DM1 plus TPC（T-DM1combined with pertuzumab or atezolizumab）， TPC（treatment of primary care）， and SG （ P ＜0.05）， for grade 1-2 pneumonitis， ARX788 and T-DXd showed significantly higher incidence than T-DM1， T-DM1 plus TPC， and TPC （ P ＜0.05）. For both indicators， ARX788 and T-Duo were ranked as the top two by SUCRA. For the incidence of grade ≥3 pneumonitis， T-DXd and T-DM1 were significantly higher than SG （ P ＜0.05）， T-Duo and Dato-DXd were ranked as the top two by SUCRA. For overall incidence of ILD， ARX788 was significantly higher than T-DM1， SHR-A1811， TPC， and SG （ P ＜0.05）， for the incidence of grade 1-2 ILD， ARX788 was significantly higher than T-DM1， SHR-A1811， and TPC （ P ＜0.05）， for the incidence of grade ≥3 ILD， ARX788 was significantly higher than TPC （ P ＜0.05）. For three indicators above， ARX788 and T-DXd combined with pertuzumab were ranked as the top two by SUCRA. CONCLUSIONS Compared with other ADCs， ARX788 and T-Duo are associated with a higher risk of pneumonitis and ILD in patients with breast cancer. |
| 期刊： | 2026年第37卷第10期 |
| 作者： | 王晓函；陈威；杨芳；曹可鸣；王靖欣；薛文鑫 |
| AUTHORS： | WANG Xiaohan，CHEN Wei，YANG Fang，CAO Keming，WANG Jingxin，XUE Wenxin |
| 关键字： | 乳腺癌；抗体偶联药物；肺炎；间质性肺病；发生风险 |
| KEYWORDS： | breast cancer； antibody-drug conjugates； |
| 阅读数： | 11 次 |
| 本月下载数： | 0 次 |
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