帕妥珠单抗治疗癌症的皮疹发生率及其发生风险的Meta分析

Incidence and Risk of Rash with the Pertuzumab in Treatment on Cancers:A Systematic Review

目的系统评价帕妥珠单抗治疗癌症的皮疹发生率及其发生风险。方法计算机检索The Cochrane Library、PubMed、EMbase、CBM、CNKI、VIP和WanFang Data数据库,收集帕妥珠单抗治疗癌症并报告皮疹发生率或其发生风险的临床试验,检索时限均从建库至2013-11-20日。由2位为评价员根据纳入与排除标准独立进行文献筛选、资料提取及质量评价后,采用CMA v2.0软件进行Meta分析。结果最终共纳入8个研究,共1726例患者。Meta分析结果显示：帕妥珠单抗治疗癌症的皮疹发生率为24.6%（95%CI：19.3%~30.8%,P〈0.001）;帕妥珠单抗治疗癌症的高级别（3/4级）皮疹发生率为1.3%（95%CI：0.6%~3.2%,P〈0.001）;帕妥珠单抗治疗癌症的皮疹发生风险为1.61倍（RR=1.61,95%CI：1.01~2.57,P=0.047）。亚组分析显示,帕妥珠单抗治疗前列腺癌皮疹发生率为13.2%（95%CI：7.9%~21.2%,P〈0.001）,较其他癌症低。结论帕妥珠单抗治疗癌症可能引起皮疹,且不同的癌症类型皮疹发生率不同。提示在应用帕妥珠单抗治疗癌症病人时,应早期发现、早期适当治疗、最优化治疗,减少病人的负担。

Objective To systematically review the incidence and risk of rash with the pertuzumab in cancer treatment.Methods The Cochrane Library,PubMed,Embase,CBM,CNKI,VIP,and WanFang Data were electronically searched for studies about the clinical trials about the incidence and risk of rash with the pertuzumab in treatment on cancers untill November 20th,2013.According to the inclusion and exclusion criteria,papers were screened and data was extracted.The meta-analysis was conducted using CMA v2.0 software.Results Eight studies involving 1726 patients were included.The results of meta-analysis showed that the incidence of all grade rash with the pertuzumab during cancers treatment was 24.6%（95%CI 19.3% to 30.8%,P〈0.001）,the incidence of 3/4 grade rash with the pertuzumab during cancers treatment was 1.3%（95%CI 0.6% to 3.2%,P〈0.001）,the risk of rash with the pertuzumab during cancers treatment was 1.61 times（RR=1.61,95%CI 1.01 to 2.57,P=0.047）.The subgroup analyses showed that the incidence of rash with the pertuzumab in treatment on prostate cancer was 13.2%（95%CI 7.9% to 21.2%,P〈0.001）and lower than those on other cancers.Conclusion Pertuzumab is associated with a significant risk of rash,and the incidence varies among different types of cancer.