PD-1/PD-L1抗体与化学药物治疗眼部不良反应比较的Meta分析

Immune-related ocular toxicities of PD-1/PD-L1 antibody versus chemotherapy for solid tumor: a meta-analysis

目的探讨细胞程序死亡蛋白1(PD-1)及配体(PD-L1)抗体与化学药物治疗(化疗)在眼部免疫相关不良反应上的差异。方法检索PubMed、EMbase、中英文数据库,时间截止为2019年12月。纳入恶性实体肿瘤采用PD-1/PD-L1抗体治疗与对照组采用化疗比较的临床研究。通过提取关键特征,应用RevMan 5.3对纳入研究进行Meta分析。应用漏斗图对纳入研究的发表偏倚进行评估。结果PD-1/PD-L1抗体与化疗相比,眼部相关免疫不良反应(1~5级)及严重不良反应(3~5级)发生率差异无统计学意义[OR=1.34,95%CI(0.64~2.80);OR=1.20,95%CI(0.35~4.08)]。漏斗图基本对称分布,偏倚可控。PD-1抗体与化疗相比,眼部相关免疫不良反应(1~5级)及严重不良反应(3~5级)发生率无统计学差异[OR=1.20,95%CI(0.55~2.65);OR=1.00,95%CI(0.26~3.86)]。PD-L1抗体与化疗相比,眼部相关免疫不良反应(1~5级)及严重不良反应(3~5级)发生率无统计学差异[OR=2.82,95%CI(0.29~27.19);OR=2.85,95%CI(0.12~70.15)]。结论免疫治疗药物PD-1/PD-L1抗体眼部免疫相关不良反应总体发生率、严重程度与化疗相比无统计学差异。

Objective To evaluate the immune-related ocular toxicities of PD-1/PD-L1 antibody versus chemotherapy in patients with solid tumors.Methods Such databases as PubMed and EMbase were searched as of December 2019.Related phaseⅡ-Ⅳcontrolled clinical trials were included.The ocular toxicities caused by PD-1/PD-L1 antibody and by chemotherapy were compared in solid tumor patients.Meta-analysis was performed using RevMan 5.3.Results There was no statistically significant difference in the risk of grade 1-5 and grade 3-5 adverse events between PD-1/PD-L1 antibody and chemotherapy[OR=1.34,95%CI(0.64-2.80);OR=1.20,95%CI(0.35-4.08)].The cases were the same with PD-1 antibody[OR=1.20,95%CI(0.55-2.65);OR=1.00,95%CI(0.26-3.86)]and PD-L1 antibody[OR=2.82,95%CI(0.29-27.19);OR=2.85,95%CI(0.12-70.15)].Conclusions Our meta-analysis demonstrates that there is no significant difference in immune-related ocular toxicities between PD-1/PD-L1 antibody and chemotherapy.