Optimal first-line treatment for platinum-eligible metastatic urothelial carcinoma Comparison of chemo-immunotherapy, immunotherapy, and chemotherapy- A systematic review and meta-analysis

Optimal first-line treatment for platinum-eligible metastatic urothelial carcinoma : Comparison of chemo-immunotherapy, immunotherapy, and chemotherapy- A systematic review and meta-analysis

Copyright © 2022. Published by Elsevier Inc.

Détails bibliographiques
Publié dans:Clinical immunology (Orlando, Fla.). - 1999. - 236(2022) vom: 01. März, Seite 108927
Auteur principal: Li, Haifeng (Auteur)
Autres auteurs: Ni, Mengqian, Xue, Cong, Li, Lu, Huang, Riqing, Yang, Wei, Hu, Anqi, An, Xin, Shi, Yanxia
Format: Article en ligne
Langue:English
Publié: 2022
Accès à la collection:Clinical immunology (Orlando, Fla.)
Sujets:Journal Article Meta-Analysis Research Support, Non-U.S. Gov't Systematic Review Immune Checkpoint Inhibitors Programmed Cell Death 1 Receptor Platinum 49DFR088MY
Description
Résumé:Copyright © 2022. Published by Elsevier Inc.
BACKGROUND: The role of first-line of immunotherapy in metastatic urothelial carcinoma (mUC) remains unclear. This meta-analysis aimed to explore an optimal first-line treatment strategy for mUC patients
METHODS: We carried out a meta-analysis between chemo-immunotherapy, immunotherapy, and chemotherapy in mUC based on randomized trials. The outcomes included overall survival (OS), progression-free survival (PFS), objective response rate (ORR), disease control rate (DCR), and treatment-related adverse events (AEs). A fixed-effect or random-effects model was adopted depending on between-study heterogeneity
RESULTS: Three trials involving 3238 patients were included. PD-1/PD-L1 inhibitor plus platinum-based chemotherapy was associated with the improvements of OS (HR, 0.85; 95% CI 0.75-0.99), PFS (HR, 0.80; 95% CI 0.71-0.90) and ORR (OR, 1.32; 95% CI 1.07-1.63) when compared with platinum-based chemotherapy, but not with better DCR (OR, 1.07; 95% CI 0.78-1.46). PD-1/PD-L1 inhibitor alone was associated with worse ORR (OR, 0.38; 95% CI 0.17-0.87) and DCR (OR, 0.20; 95% CI 0.16-0.25) when compared with platinum-based chemotherapy while it did not statistically reduce the risk of mortality (HR 0.97 for entire cohort; 0.90 for PD-L1 high cohort). In safety analyses, the incidence of adverse events (AEs) between regimens showed no difference, but the frequency of AEs of grade 3 or severity was higher in chemo-immunotherapy compared to chemotherapy
CONCLUSIONS: Compared with platinum-based chemotherapy, chemo-immunotherapy is associated with significantly improved PFS, OS, and ORR in the first-line therapy for mUC at the expanse of increased toxicity
Description:Date Completed 06.05.2022
Date Revised 06.05.2022
published: Print-Electronic
Citation Status MEDLINE
ISSN:1521-7035
DOI:10.1016/j.clim.2022.108927