EGFR突變陽性的晚期非小細胞肺癌患者奧西替尼聯(lián)合免疫檢查點阻斷劑治療與奧西替尼單藥治療使用療效和安全性Meta分析

吳柳盛 李小強

[摘要] 目的 采用Meta分析比較晚期非小細胞肺癌患者奧西替尼聯(lián)合免疫檢查點阻斷劑治療與奧西替尼單藥治療使用的療效和安全性。 方法 通過電腦手動檢索Pubmed、SAGE、Embase、中國知網(wǎng)（CNKI）、Cochrane、UpToDate、JAMA等有關(guān)非小細胞肺癌奧西替尼聯(lián)合免疫檢查點阻斷治療與奧西替尼單藥治療的文獻資料，檢索時間為2000年7月至2020年7月，采用Cochrane循證醫(yī)學(xué)中心的評價原則對文獻進行質(zhì)量評價。 結(jié)果 最終納入15篇符合條件的隨機對照試驗文獻，共計3106例患者。在療效性方面，奧西替尼結(jié)合免疫檢查點阻斷劑治療組和奧西替尼治療組客觀緩解率比較，差異無統(tǒng)計學(xué)意義（OR：1.59，95%CI：1.36～1.87，P>0.05），無進展生存期差異有統(tǒng)計學(xué)意義（OR：0.89， 95%CI：0.74～1.07，P<0.00001）;在安全性方面，奧西替尼聯(lián)合免疫檢查點阻斷劑治療組不良反應(yīng)事件發(fā)生率低于奧西替尼治療組（RR：0.67，95%CI：0.56～0.81，P<0.0001）。 結(jié)論 奧西替尼聯(lián)合免疫檢查點阻斷劑治療晚期非小細胞肺癌的療效明顯優(yōu)于奧西替尼單藥治療，而且不良反應(yīng)事件發(fā)生率亦無明顯增加。

[關(guān)鍵詞] 非小細胞肺癌;靶向治療;EGFR-TKI;免疫檢查點阻斷劑;Meta分析

[中圖分類號] R734.2;R730.53;R453? ? ? ? ?[文獻標識碼] A? ? ? ? ?[文章編號] 1673-9701（2021）06-0028-06

Meta-analysis of the efficacy and medication safety of oxitinib combined with immune checkpoint blockers and oxitinib monotherapy in patients with advanced non-small cell lung cancer with positive EGFR mutation

WU Liusheng 1， 2， 3 LI Xiaoqiang1， 3

1.Peking University Shenzhen Hospital， Clinical College of Anhui Medical University， Shenzhen 518036， China; 2.Department of Graduate School， Anhui Medical University， Hefei? ?230032， China; 3.Department of Thoracic Surgery， Peking University Shenzhen Hospital， Shenzhen? ?518036， China

[Abstract] Objective To apply the meta-analysis and compare the efficacy and medication safety of oxitinib combined with immune checkpoint blockers and oxitinib monotherapy in patients with advanced non-small cell lung cancer. Methods The literatures about the combination of oxitinib and immune checkpoint blocking treatment for non-small cell lung cancer in PubMed， SAGE， Embase， Chinese National Knowledge Infrastructure（CNKI）， Cochrane， UpToDate， JAMA， etc. from July 2000 to July 2020 were manually searched. The evaluation principle of Cochrane Evidence-based Medicine Center was used to evaluate the quality of literatures. Results Finally， 15 eligible randomized controlled trials were included，with a total of 3106 patients. In terms of therapeutic efficacy， there was no significant difference of the objective remission rate between the oxitinib combined with immune checkpoint blocker treatment group and the oxitinib treatment group， difference of the objective remission rate was not statistically significant and the oxltinib treatment group（OR：1.59， 95%CI：1.36-1.87， P>0.05）， while difference of the progression-free survival time was statistically significant（OR：0.89， 95%CI：0.74-1.07， P<0.00001）. In terms of medication safety， the incidence of adverse reaction events in the oxitinib combined with immune checkpoint blocker treatment group was lower than that in the oxitinib treatment group（RR：0.67， 95%CI： 0.56-0.81， P<0.0001）. Conclusion Oxitinib combined with immune checkpoint blockers treatment is superior to oxitinib monotherapy in the treatment of advanced non-small cell lung cancer，and the incidence of adverse reaction events has not increased significantly.