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完整後設資料紀錄
DC 欄位 | 值 | 語言 |
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dc.contributor.advisor | 林家齊(Chia-Chi Lin) | |
dc.contributor.author | Miao-Ting Lin | en |
dc.contributor.author | 林妙亭 | zh_TW |
dc.date.accessioned | 2021-06-15T16:11:18Z | - |
dc.date.available | 2020-08-26 | |
dc.date.copyright | 2020-08-26 | |
dc.date.issued | 2020 | |
dc.date.submitted | 2020-08-09 | |
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dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/52298 | - |
dc.description.abstract | 1. 研究簡介 背景 歐洲紫杉醇(docetaxel)於1999年是第一個被美國FDA核准用於非小細胞肺癌(non-small cell lung cancer, NSCLC)第二線治療的藥物,並自此成為標準療法之一。然而,免疫檢查點疫制劑(immune checkpoint inhibitors)例如:anti-PD-1 or PD-L1 antibodies 的發展,其對病人較佳的存活益處和較低的毒性,對於晚期非小細胞肺癌的治療帶來很大的進步。 目的 本研究的目的主要是透過系統性文獻回顧和統合分析的方式,來整合評估免疫檢查點疫制劑(anti-PD-1 or PD-L1 antibodies)作為非小細胞肺癌第二線治療之整體有效性及安全性,納入分析的試驗將以隨機對照試驗為主。 2. 研究方法 資料搜尋策略 於2019年11月中至12月初經由PubMed/Medline電子資料庫進行文獻搜尋,使用的關鍵字為non-small cell lung cancer AND PD-L1 OR PD-1 AND docetaxel,並以Clinical Trial來篩選搜尋結果。 3. 研究結果 總共有5個符合條件的試驗納入統合分析。研究結果顯示,整體存活時間(overall survival, OS)在anti-PD-1 or PD-L1 antibodies治療組優於docetaxel 治療組(HR=0.72, 95% CI= 0.64-0.81, p=0.000),且在anti-PD-1 or PD-L1 antibodies治療組也有較佳的目標治療反應率(objective response rate, ORR)(OR=1.75, 95% CI= 1.33-2.31, p=0.000)。然而,無疾病惡化存活(progression-free survival, PFS)於兩種治療組的比較卻沒有達到統計上的顯著差異(HR=0.89, 95% CI= 0.77-1.02, p=0.088). 此外,anti-PD-1 or PD-L1 antibodies 治療相關的不良事件,無論在所有等級(OR=0.33, 95% CI=0.28-0.39, p=0.000)或第3和第4等級嚴重程度(OR=0.17, 95% CI=0.26-0.10, p=0.000)的事件,均少於化學治療組。 4. 研究結論 對於先前治療但失敗或疾病惡化的非小細胞肺癌病人,免疫檢查點疫制劑如anti-PD-1 or PD-L1 antibodies作為二線治療確實可改善病人的存活,且有較佳的抗腫瘤效果,並提供了良好的安全性。 | zh_TW |
dc.description.abstract | 1. Introduction Rationale Docetaxel was the first drug approved by FDA in 1999 as the second-line therapy in non-small cell lung cancer patients, and has been the standard of care since then. However, the development of immune checkpoint inhibitors such as anti-PD-1 or PD-L1 antibodies have been a great advance in treating advanced NSCLC, which have shown better surviv-al benefit and safety profile. Objective The aim of this systematic review and meta-analysis of randomized controlled trials is to evaluate the efficacy and safety of Immune checkpoint inhibitors (anti-PD-1 or PD-L1 antibodies)as second-line treatment in previously treated NSCLC patients. 2. Methods Search strategy Literature search was performed through the electronic database of PubMed/Medline between mid-November and early December 2019 by using keywords related to the PI-CO elements. The following keywords were used: non-small cell lung cancer AND PD-L1 OR PD-1 AND docetaxel, and are filtered by Clinical Trial. 3. Results Five studies were selected for the meta-analysis. Pooled analysis of OS (HR=0.72, 95% CI= 0.64-0.81, p=0.000) and ORR (OR=1.75, 95% CI= 1.33-2.31, p=0.000) fa-vored anti-PD-1 or PD-L1 antibodies. However, the analysis of PFS did not reach statis-tical significance (HR=0.89, 95% CI= 0.77-1.02, p=0.088). In addition, the analysis showed that anti-PD-1 or PD-L1 antibodies group has fewer TRAEs than docetaxel group, either in terms of any grade (OR=0.33, 95% CI=0.28-0.39, p=0.000) or grade 3/4 events (OR=0.17, 95% CI=0.26-0.10, p=0.000). 4. Conclusion Immune checkpoint inhibitors such as anti-PD-1 or PD-L1 antibodies could enhance the survival benefit and antitumor response as second-line treatment for previously treated advanced NSCLC. They also provide favorable safety profile. | en |
dc.description.provenance | Made available in DSpace on 2021-06-15T16:11:18Z (GMT). No. of bitstreams: 1 U0001-0708202001073300.pdf: 2495098 bytes, checksum: d4ae2f52f21f3348575fa9d061ed493c (MD5) Previous issue date: 2020 | en |
dc.description.tableofcontents | CHINESE SUMMARY 5 ENGLISH SUMMARY 7 SYSTEMATIC REVIEW META-ANALYSIS 9 1. INTRODUCTION 9 1.1 Rationale 9 1.2 Objective 11 2. METHODS 11 2.1 Eligibility criteria 11 2.2 Search strategy 11 2.3 Outcomes and Prioritization 11 2.4 Risk of Bias in Individual Studies 12 3. SEARCH RESULTS 12 4. ANALYSIS RESULTS 13 4.1 Characteristics of selected studies 13 4.2 Risk of bias 14 4.3 Overall Survival 14 4.4 Progression-Free Survival 15 4.5 Objective Response Rate 15 4.6 Treatment-related Adverse Events 16 5. DISCUSSIONS 18 6. CONCLUSION 20 REFERENCES 21 LIST OF TABLES 24 LIST OF FIGURES 34 APPENDIX: PROPOSED PROTOCOL 44 | |
dc.language.iso | zh-TW | |
dc.title | 免疫檢查點抑制劑作為非小細胞肺癌病人第二線治療之研究 | zh_TW |
dc.title | Immune checkpoint inhibitors (anti-PD-1 or PD-L1 antibodies) as the second-line therapy (vs. docetaxel) in non-small cell lung cancer population | en |
dc.type | Thesis | |
dc.date.schoolyear | 108-2 | |
dc.description.degree | 碩士 | |
dc.contributor.oralexamcommittee | 陳祈玲(Chi-Ling Chen),何肇基(Chao-Chi Ho) | |
dc.subject.keyword | 歐洲紫杉醇,免疫檢查點抑制劑,非小細胞肺癌,PD-1,PD-L1, | zh_TW |
dc.subject.keyword | docetaxel,immune checkpoint inhibitors,NSCLC,PD-1,PD-L1, | en |
dc.relation.page | 107 | |
dc.identifier.doi | 10.6342/NTU202002595 | |
dc.rights.note | 有償授權 | |
dc.date.accepted | 2020-08-10 | |
dc.contributor.author-college | 醫學院 | zh_TW |
dc.contributor.author-dept | 臨床醫學研究所 | zh_TW |
顯示於系所單位: | 臨床醫學研究所 |
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