請用此 Handle URI 來引用此文件:
http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/59428
標題: | 非小細胞肺癌免疫治療和化學治療併用系統性回顧和統合分析、第三期臨床試驗計畫書 Immunotherapy in Combination with Chemotherapy for Non-Small Cell Lung Cancer: A Systematic Review and Meta-Analysis, A Phase III Clinical Study Protocol |
作者: | Yueh-Ping Tseng 曾月萍 |
指導教授: | 林家齊(Chia-Chi Lin) |
關鍵字: | 非小細胞肺癌,化學療法,免疫療法,統合分析,系統性回顧, atezolizumab,chemotherapy,immunotherapy,meta-analysis,non–Small cell lung cancer,pembrolizumab,systematic review, |
出版年 : | 2020 |
學位: | 碩士 |
摘要: | 背景: 研究顯示針對第四期非小細胞肺癌患者,免疫療法合併化學療法的治療效果優於標準化療單獨使用,進行系統性文獻回顧和統合分析,探討第四期非小細胞肺癌以免疫療法合併化學療法與標準化療單獨使用的治療效果以及不良反應發生率的評估。 方法: 從電子資料庫和相關會議記錄搜尋的資料進行系統性文獻回顧和統合分析。評估免疫療法合併化學療法與標準化療單獨使用對整體存活期(OS),無惡化存活時間(PFS)的影響差異。同時評估免疫療法合併化學療法與標準化療單獨使用的不良事件發生率。 結果: 五篇研究論文和兩篇研究會議記錄進行統合分析。以免疫療法合併化學療法比上標準化療單獨使用,整體存活期的危險傷害比(Hazard ratio)和無惡化存活時間的危險傷害比皆有增加,其對應的危險傷害比分別為Hazard ratio 0.72; 95% CI, 0.61 to 0.84; p < 0.0001和Hazard ratio 0.61; 95% CI, 0.57 to 0.66; p < 0.00001;不良反應的風險比(Risk ratio)在任何等級為1.02倍 (95% CI, 1.01 to 1.04)、在3-5等級為1.15倍 (95% CI, 1.09 to 1.21)。 結論: 治療第四期非小細胞肺癌,以免疫療法合併化學治療與標準化療單獨使用比較,顯著增加整體存活期和無惡化存活時間,不良事件發生率也顯著偏高。 Background Studies show that immunotherapy in combination with chemotherapy had a higher efficacy benefit than chemotherapy alone as the first line treatment for stage IV non-small cell lung cancer (NSCLC) (Borghaei et al., 2019; Gandhi et al., 2018; Paz-Ares et al., 2018; Socinski et al., 2018; West et al., 2019). A systematic review and meta-analysis were conducted to explore the efficacy and adverse effects of immunotherapy in combination with chemotherapy versus chemotherapy alone for stage IV NSCLC patients. Method Data from electronic databases and relevant conference proceedings were obtained for analysis. The focus was to evaluate the treatment effect on the overall survival (OS) and progression free survival (PFS). In addition, adverse events were also assessed. Results Five studies in quantitative synthesis and two conference proceedings were used for the meta-analysis (Barlesi, 2019; Borghaei et al., 2019; Gandhi et al., 2018; Jotte, 2019; Paz-Ares et al., 2018; Socinski et al., 2018; West et al., 2019). Results show that the combined immunotherapy and chemotherapy for Stage IV NSCLC when compared with chemotherapy alone significantly increased the OS (Hazard ratio 0.72; 95% CI, 0.61 to 0.84; p < 0.0001) and PFS (Hazard ratio 0.61; 95% CI, 0.57 to 0.66; p < 0.00001). The Risk Ratio for adverse events of any grade and grade 3-5 were respectively 1.02 (95% CI, 1.01 to 1.04) and 1.15 (95% CI, 1.09 to 1.21) (Figure 4, Figure 5, Figure 6 and Figure7). Conclusion For Stage IV NSCLC, the combined immunotherapy and chemotherapy when compared with chemotherapy alone significantly improved the treatment effect related to OS and PFS. Moreover, the adverse events of the immunotherapy in combination with chemotherapy had a higher incidence than chemotherapy alone. |
URI: | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/59428 |
DOI: | 10.6342/NTU202003378 |
全文授權: | 有償授權 |
顯示於系所單位: | 臨床醫學研究所 |
文件中的檔案:
檔案 | 大小 | 格式 | |
---|---|---|---|
U0001-1408202010263200.pdf 目前未授權公開取用 | 1.52 MB | Adobe PDF |
系統中的文件,除了特別指名其著作權條款之外,均受到著作權保護,並且保留所有的權利。