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Efficacy of Cancer Immunotherapy: An Umbrella Review of Meta-Analyses of Randomized Controlled Trials

We conducted a systematic review for evidence of the clinical efficacy of cancer immunotherapies. We searched PubMed from inception to 14 February 2018 for meta-analyses of randomized controlled trials (RCTs) of cancer immunotherapies. Re-analyses were performed to estimate the summary effect size u...

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Autores principales: Kim, Jong Yeob, Lee, Keum Hwa, Eisenhut, Michael, van der Vliet, Hans J., Kronbichler, Andreas, Jeong, Gwang Hun, Shin, Jae Il, Gamerith, Gabriele
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6895783/
https://www.ncbi.nlm.nih.gov/pubmed/31731818
http://dx.doi.org/10.3390/cancers11111801
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author Kim, Jong Yeob
Lee, Keum Hwa
Eisenhut, Michael
van der Vliet, Hans J.
Kronbichler, Andreas
Jeong, Gwang Hun
Shin, Jae Il
Gamerith, Gabriele
author_facet Kim, Jong Yeob
Lee, Keum Hwa
Eisenhut, Michael
van der Vliet, Hans J.
Kronbichler, Andreas
Jeong, Gwang Hun
Shin, Jae Il
Gamerith, Gabriele
author_sort Kim, Jong Yeob
collection PubMed
description We conducted a systematic review for evidence of the clinical efficacy of cancer immunotherapies. We searched PubMed from inception to 14 February 2018 for meta-analyses of randomized controlled trials (RCTs) of cancer immunotherapies. Re-analyses were performed to estimate the summary effect size under random-effects, the 95% confidence interval (CI), heterogeneity, and the 95% prediction interval, and we determined the strength of the evidence. We examined publication bias and excess significance bias. 63 articles corresponding to 247 meta-analyses were eligible. Nine meta-analyses were classified to have convincing evidence, and 75 were classified as suggestive evidence. The clinical benefit of immunotherapy was supported by convincing evidence in the following settings: anti-PD-1/PD-L1 monoclonal antibody (mAb) therapy for treating advanced melanoma and non-small cell lung cancer (NSCLC), the combination of rituximab and chemotherapy for treating chronic lymphocytic leukemia and B-cell non-Hodgkin’s lymphoma, adoptive cell immunotherapy for NSCLC, and the combination of interferon α and chemotherapy for metastatic melanoma. A further meta-analysis of 16 RCTs showed that anti-PD-1/PD-L1 mAb therapy had a benefit in patients with solid tumors (overall survival; hazard ratio = 0.73, 95% CI: 0.68–0.79; p < 0.001), supported by convincing evidence. In the future, rigorous approaches are needed when interpreting meta-analyses to gain better insight into the true efficacy of cancer immunotherapy.
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spelling pubmed-68957832019-12-24 Efficacy of Cancer Immunotherapy: An Umbrella Review of Meta-Analyses of Randomized Controlled Trials Kim, Jong Yeob Lee, Keum Hwa Eisenhut, Michael van der Vliet, Hans J. Kronbichler, Andreas Jeong, Gwang Hun Shin, Jae Il Gamerith, Gabriele Cancers (Basel) Article We conducted a systematic review for evidence of the clinical efficacy of cancer immunotherapies. We searched PubMed from inception to 14 February 2018 for meta-analyses of randomized controlled trials (RCTs) of cancer immunotherapies. Re-analyses were performed to estimate the summary effect size under random-effects, the 95% confidence interval (CI), heterogeneity, and the 95% prediction interval, and we determined the strength of the evidence. We examined publication bias and excess significance bias. 63 articles corresponding to 247 meta-analyses were eligible. Nine meta-analyses were classified to have convincing evidence, and 75 were classified as suggestive evidence. The clinical benefit of immunotherapy was supported by convincing evidence in the following settings: anti-PD-1/PD-L1 monoclonal antibody (mAb) therapy for treating advanced melanoma and non-small cell lung cancer (NSCLC), the combination of rituximab and chemotherapy for treating chronic lymphocytic leukemia and B-cell non-Hodgkin’s lymphoma, adoptive cell immunotherapy for NSCLC, and the combination of interferon α and chemotherapy for metastatic melanoma. A further meta-analysis of 16 RCTs showed that anti-PD-1/PD-L1 mAb therapy had a benefit in patients with solid tumors (overall survival; hazard ratio = 0.73, 95% CI: 0.68–0.79; p < 0.001), supported by convincing evidence. In the future, rigorous approaches are needed when interpreting meta-analyses to gain better insight into the true efficacy of cancer immunotherapy. MDPI 2019-11-15 /pmc/articles/PMC6895783/ /pubmed/31731818 http://dx.doi.org/10.3390/cancers11111801 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Kim, Jong Yeob
Lee, Keum Hwa
Eisenhut, Michael
van der Vliet, Hans J.
Kronbichler, Andreas
Jeong, Gwang Hun
Shin, Jae Il
Gamerith, Gabriele
Efficacy of Cancer Immunotherapy: An Umbrella Review of Meta-Analyses of Randomized Controlled Trials
title Efficacy of Cancer Immunotherapy: An Umbrella Review of Meta-Analyses of Randomized Controlled Trials
title_full Efficacy of Cancer Immunotherapy: An Umbrella Review of Meta-Analyses of Randomized Controlled Trials
title_fullStr Efficacy of Cancer Immunotherapy: An Umbrella Review of Meta-Analyses of Randomized Controlled Trials
title_full_unstemmed Efficacy of Cancer Immunotherapy: An Umbrella Review of Meta-Analyses of Randomized Controlled Trials
title_short Efficacy of Cancer Immunotherapy: An Umbrella Review of Meta-Analyses of Randomized Controlled Trials
title_sort efficacy of cancer immunotherapy: an umbrella review of meta-analyses of randomized controlled trials
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6895783/
https://www.ncbi.nlm.nih.gov/pubmed/31731818
http://dx.doi.org/10.3390/cancers11111801
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