Cargando…
A meta-analysis of the efficacy and safety of PD-1/PD-L1 immune checkpoint inhibitors as treatments for metastatic bladder cancer
BACKGROUND: This article is a meta-analysis aiming to systematically assess the efficacy and safety profiles of PD-1/PD-L1 inhibitors in patients with advanced or metastatic bladder cancer. METHODS: We extracted and examined data from phase I, II, and III clinical trials from the Medline, Embase, an...
Autores principales: | , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Dove Medical Press
2019
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6404681/ https://www.ncbi.nlm.nih.gov/pubmed/30881032 http://dx.doi.org/10.2147/OTT.S186271 |
_version_ | 1783400941038338048 |
---|---|
author | Fan, Zhongyuan Liang, Ye Yang, Xuecheng Li, Bin Cui, Lili Luo, Lei Jia, Yuefeng Wang, Yonghua Niu, Haitao |
author_facet | Fan, Zhongyuan Liang, Ye Yang, Xuecheng Li, Bin Cui, Lili Luo, Lei Jia, Yuefeng Wang, Yonghua Niu, Haitao |
author_sort | Fan, Zhongyuan |
collection | PubMed |
description | BACKGROUND: This article is a meta-analysis aiming to systematically assess the efficacy and safety profiles of PD-1/PD-L1 inhibitors in patients with advanced or metastatic bladder cancer. METHODS: We extracted and examined data from phase I, II, and III clinical trials from the Medline, Embase, and the Cochrane Library, which included patients with metastatic bladder cancer who were treated with PD-1/PD-L1 inhibitors. We performed a meta-analysis to investigate several indexes of efficacy and safety, including the objective response rate (ORR), 1-year overall survival (OS) rate, 1-year progression-free survival (PFS) rate, and adverse event (AE) rate of immune checkpoint inhibitors. The material data were calculated and pooled using The R Project for Statistical Computing and Review Manager 5.3. RESULTS: After excluding ineligible records, 14 clinical trials were included in our analysis. The pooled frequencies of all-grade AEs and grade ≥3 AEs were 0.63 (95% CI 0.61–0.65, P=0.34) and 0.14 (95% CI 0.11–0.17, P=0.0072), respectively. The summary ORR was 0.21 (95% CI 0.18–0.24 P=0.07), and the 1-year OS and 1-year PFS rates were 0.48 (95% CI 0.42–0.54 P=0.0013) and 0.21 (95% CI 0.16–0.26 P=0.04), respectively. The OR of ORR between the PD-L1-positive and -negative groups was 3.09 (95% CI 2.01–4.75, P=0.08). CONCLUSION: The PD-1/PD-L1 therapy showed appropriate efficacy and acceptable incidence of treatment-related AEs. In addition, the level of discrimination of PD-L1 expression might be related to the effect of the PD-1/PD-L1 inhibitors, and patients displaying positive expression might experience a better curative effect than patients displaying negative expression. |
format | Online Article Text |
id | pubmed-6404681 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Dove Medical Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-64046812019-03-16 A meta-analysis of the efficacy and safety of PD-1/PD-L1 immune checkpoint inhibitors as treatments for metastatic bladder cancer Fan, Zhongyuan Liang, Ye Yang, Xuecheng Li, Bin Cui, Lili Luo, Lei Jia, Yuefeng Wang, Yonghua Niu, Haitao Onco Targets Ther Original Research BACKGROUND: This article is a meta-analysis aiming to systematically assess the efficacy and safety profiles of PD-1/PD-L1 inhibitors in patients with advanced or metastatic bladder cancer. METHODS: We extracted and examined data from phase I, II, and III clinical trials from the Medline, Embase, and the Cochrane Library, which included patients with metastatic bladder cancer who were treated with PD-1/PD-L1 inhibitors. We performed a meta-analysis to investigate several indexes of efficacy and safety, including the objective response rate (ORR), 1-year overall survival (OS) rate, 1-year progression-free survival (PFS) rate, and adverse event (AE) rate of immune checkpoint inhibitors. The material data were calculated and pooled using The R Project for Statistical Computing and Review Manager 5.3. RESULTS: After excluding ineligible records, 14 clinical trials were included in our analysis. The pooled frequencies of all-grade AEs and grade ≥3 AEs were 0.63 (95% CI 0.61–0.65, P=0.34) and 0.14 (95% CI 0.11–0.17, P=0.0072), respectively. The summary ORR was 0.21 (95% CI 0.18–0.24 P=0.07), and the 1-year OS and 1-year PFS rates were 0.48 (95% CI 0.42–0.54 P=0.0013) and 0.21 (95% CI 0.16–0.26 P=0.04), respectively. The OR of ORR between the PD-L1-positive and -negative groups was 3.09 (95% CI 2.01–4.75, P=0.08). CONCLUSION: The PD-1/PD-L1 therapy showed appropriate efficacy and acceptable incidence of treatment-related AEs. In addition, the level of discrimination of PD-L1 expression might be related to the effect of the PD-1/PD-L1 inhibitors, and patients displaying positive expression might experience a better curative effect than patients displaying negative expression. Dove Medical Press 2019-03-04 /pmc/articles/PMC6404681/ /pubmed/30881032 http://dx.doi.org/10.2147/OTT.S186271 Text en © 2019 Fan et al. This work is published and licensed by Dove Medical Press Limited The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. |
spellingShingle | Original Research Fan, Zhongyuan Liang, Ye Yang, Xuecheng Li, Bin Cui, Lili Luo, Lei Jia, Yuefeng Wang, Yonghua Niu, Haitao A meta-analysis of the efficacy and safety of PD-1/PD-L1 immune checkpoint inhibitors as treatments for metastatic bladder cancer |
title | A meta-analysis of the efficacy and safety of PD-1/PD-L1 immune checkpoint inhibitors as treatments for metastatic bladder cancer |
title_full | A meta-analysis of the efficacy and safety of PD-1/PD-L1 immune checkpoint inhibitors as treatments for metastatic bladder cancer |
title_fullStr | A meta-analysis of the efficacy and safety of PD-1/PD-L1 immune checkpoint inhibitors as treatments for metastatic bladder cancer |
title_full_unstemmed | A meta-analysis of the efficacy and safety of PD-1/PD-L1 immune checkpoint inhibitors as treatments for metastatic bladder cancer |
title_short | A meta-analysis of the efficacy and safety of PD-1/PD-L1 immune checkpoint inhibitors as treatments for metastatic bladder cancer |
title_sort | meta-analysis of the efficacy and safety of pd-1/pd-l1 immune checkpoint inhibitors as treatments for metastatic bladder cancer |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6404681/ https://www.ncbi.nlm.nih.gov/pubmed/30881032 http://dx.doi.org/10.2147/OTT.S186271 |
work_keys_str_mv | AT fanzhongyuan ametaanalysisoftheefficacyandsafetyofpd1pdl1immunecheckpointinhibitorsastreatmentsformetastaticbladdercancer AT liangye ametaanalysisoftheefficacyandsafetyofpd1pdl1immunecheckpointinhibitorsastreatmentsformetastaticbladdercancer AT yangxuecheng ametaanalysisoftheefficacyandsafetyofpd1pdl1immunecheckpointinhibitorsastreatmentsformetastaticbladdercancer AT libin ametaanalysisoftheefficacyandsafetyofpd1pdl1immunecheckpointinhibitorsastreatmentsformetastaticbladdercancer AT cuilili ametaanalysisoftheefficacyandsafetyofpd1pdl1immunecheckpointinhibitorsastreatmentsformetastaticbladdercancer AT luolei ametaanalysisoftheefficacyandsafetyofpd1pdl1immunecheckpointinhibitorsastreatmentsformetastaticbladdercancer AT jiayuefeng ametaanalysisoftheefficacyandsafetyofpd1pdl1immunecheckpointinhibitorsastreatmentsformetastaticbladdercancer AT wangyonghua ametaanalysisoftheefficacyandsafetyofpd1pdl1immunecheckpointinhibitorsastreatmentsformetastaticbladdercancer AT niuhaitao ametaanalysisoftheefficacyandsafetyofpd1pdl1immunecheckpointinhibitorsastreatmentsformetastaticbladdercancer AT fanzhongyuan metaanalysisoftheefficacyandsafetyofpd1pdl1immunecheckpointinhibitorsastreatmentsformetastaticbladdercancer AT liangye metaanalysisoftheefficacyandsafetyofpd1pdl1immunecheckpointinhibitorsastreatmentsformetastaticbladdercancer AT yangxuecheng metaanalysisoftheefficacyandsafetyofpd1pdl1immunecheckpointinhibitorsastreatmentsformetastaticbladdercancer AT libin metaanalysisoftheefficacyandsafetyofpd1pdl1immunecheckpointinhibitorsastreatmentsformetastaticbladdercancer AT cuilili metaanalysisoftheefficacyandsafetyofpd1pdl1immunecheckpointinhibitorsastreatmentsformetastaticbladdercancer AT luolei metaanalysisoftheefficacyandsafetyofpd1pdl1immunecheckpointinhibitorsastreatmentsformetastaticbladdercancer AT jiayuefeng metaanalysisoftheefficacyandsafetyofpd1pdl1immunecheckpointinhibitorsastreatmentsformetastaticbladdercancer AT wangyonghua metaanalysisoftheefficacyandsafetyofpd1pdl1immunecheckpointinhibitorsastreatmentsformetastaticbladdercancer AT niuhaitao metaanalysisoftheefficacyandsafetyofpd1pdl1immunecheckpointinhibitorsastreatmentsformetastaticbladdercancer |