血管生成抑制剂对晚期软组织肉瘤疗效的Meta分析
|
摘要
目的对血管生成抑制剂对软组织肉瘤的疗效进行Meta分析。方法计算机检索PubMed、The Cochrane Library、EMbase、CNKI数据库,按照纳入和排除标准筛选文献和提取资料,选取血管生成抑制剂治疗晚期软组织肉瘤的随机对照临床试验,采用RevMan 5.3软件进行Meta分析。检索时限均为各数据库建库起至2019年1月。结果最终纳入8篇文献,包括991例患者。Meta分析结果显示,血管生成抑制剂能有效改善半年疾病无进展率[OR=2.44,95%CI(1.11,5.38),P=0.03]、客观反应率[OR=1.89,95%CI(1.15,3.10),P=0.01]、疾病控制率[OR=3.33,95%CI(2.46,4.53),P <0.00 001],差异有统计学意义。半年生存率差异无统计学意义[OR=0.94,95%CI(0.66,1.32),P=0.71]。结论血管生成抑制剂对晚期软组织肉瘤产生了较好疗效,能有效改善半年疾病无进展率、客观反应率、疾病控制率,在临床治疗中有使用价值。
Objective To evaluate the clinical effect of angiogenesis inhibitors on the advanced soft tissue sarcoma by Meta-analysis. Methods The database of PubMed, The Cochrane Library, EMbase and CNKI were searched by computer. After selecting the documents and extracting the data according to the inclusion and exclusion criteria, the randomized controlled clinical trials of angiogenesis inhibitors in the treatment of advanced soft tissue sarcoma was selected, and RevMan 5.3 was selected to work out the Meta-analysis. The search time was from begin of database to January 2019. Results 8 RCTs including 991 cases of patients were identified. Meta analysis showed that angiogenesis inhibitors can effectively improve the rate of progress in half a year [OR = 2.44, 95%CI(1.11, 5.38), P = 0.03], objective reaction rate [OR = 1.89, 95%CI(1.15, 3.10), P = 0.01] and disease control [OR = 3.33, 95%CI(2.46, 4.53), P < 0.00 001],there was no significant difference between angiogenesis inhibitors and control group in the half-year survival rate [OR =0.94, 95%CI(0.66, 1.32), P = 0.71]. Conclusion Angiogenesis inhibitors are effective in the treatment of advanced soft tissue sarcoma, they can effectively improve the rate of progress in half a year, objective reaction rate and disease control and they are valuable in clinical treatment.
Objective To evaluate the clinical effect of angiogenesis inhibitors on the advanced soft tissue sarcoma by Meta-analysis. Methods The database of PubMed, The Cochrane Library, EMbase and CNKI were searched by computer. After selecting the documents and extracting the data according to the inclusion and exclusion criteria, the randomized controlled clinical trials of angiogenesis inhibitors in the treatment of advanced soft tissue sarcoma was selected, and RevMan 5.3 was selected to work out the Meta-analysis. The search time was from begin of database to January 2019. Results 8 RCTs including 991 cases of patients were identified. Meta analysis showed that angiogenesis inhibitors can effectively improve the rate of progress in half a year [OR = 2.44, 95%CI(1.11, 5.38), P = 0.03], objective reaction rate [OR = 1.89, 95%CI(1.15, 3.10), P = 0.01] and disease control [OR = 3.33, 95%CI(2.46, 4.53), P < 0.00 001],there was no significant difference between angiogenesis inhibitors and control group in the half-year survival rate [OR =0.94, 95%CI(0.66, 1.32), P = 0.71]. Conclusion Angiogenesis inhibitors are effective in the treatment of advanced soft tissue sarcoma, they can effectively improve the rate of progress in half a year, objective reaction rate and disease control and they are valuable in clinical treatment.
引文
[1]Kneisl JS,Coleman MM,Raut CP.Outcomes in the management of adult soft tissue sarcomas[J]. Int J Surg Oncol,2014,110(5):527-538.
[2]Ducimetiere F,Lurkin A,Ranchere-vince D,et al. Incidence of sarcoma histotypes and molecular subtypes in a prospective epidemiological study with central pathology review and molecular testing[J]. PLoS One,2011,6(8):e20294.
[3]NG VY,Scharschmidt TJ,Mayerson JL,et al. Incidence and survival in sarcoma in the United States:a focus on musculoskeletal lesions[J]. Anticancer Res,2013,33(6):2597-2604.
[4]Kampann E,Altendorf-hofmann A,Gibis S,et al. VEGFR2predicts decreased patients survival in soft tissue sarcomas[J].Pathol Res Pract,2015,211(10):726-730.
[5]Rocchi L,Caraffi S,Perris R,et al. The angiogenic asset of soft tissue sarcomas:a new tool to discover new therapeutic targets[J]. Biosci Rep,2014,34(6):e00147.
[6]Tammela T,Enholm B,Alitalo K,et al. The biology of vascular endothelial growth factors[J]. Cardiovasc Res,2005,65(3):550-563.
[7]Gacche RN,Meshram RJ.Angiogenic factors as potential drug target:efficacy and limitations of anti-angiogenic therapy[J]. Biochim Biophys Acta,2014,1846(1):161-179.
[8]Hensley ML,Miller A,O′malley DM,et al. Randomized phaseⅢtrial of gemcitabine plus docetaxel plus bevacizumab or placebo as first-line treatment for metastatic uterine leiomyosarcoma:an NRG Oncology/Gynecologic Oncology Group study[J]. J Clin Oncol,2015,33(10):1180-1185.
[9]Mir O,Brodowicz T,Italiano A,et al. Safety and efficacy of regorafenib in patients with advanced soft tissue sarcoma(REGOSARC):a randomised,double-blind,placebo-controlled,phase 2 trial[J]. Lancet Oncol,2016,17(12):1732-1742.
[10]Ray-coquard IL,Domont J,Tresch-brunee E,et al. Paclitaxel given once per week with or without bevacizumab in patients with advanced angiosarcoma:a randomized phaseⅡtrial[J]. J Clin Oncol,2015,33(25):2797-2802.
[11]Van Der Graaf WTA,Blay JY,Chawla SP,et al. Pazopanib for metastatic soft-tissue sarcoma(PALETTE):a randomised,double-blind,placebo-controlled phase 3trial[J]. Lancet,2012,379(9829):1879-1886.
[12]Chisholm JC,Merks JHM,Casanova M,et al. Open-label,multicentre,randomised,phaseⅡstudy of the EpSSG and the ITCC evaluating the addition of bevacizumab to chemotherapy in childhood and adolescent patients with metastatic soft tissue sarcoma(the BERNIE study)[J].Eur J Cancer,2017,83(1):77-84.
[13]刘佳勇,樊征夫,李舒,等.盐酸安罗替尼胶囊治疗晚期软组织肉瘤Ⅱb期多中心临床试验的单中心数据分析[J].中国肿瘤临床,2018,45(20):1066-1070.
[14]张殿宝,康议心,郭艳珍.恩度联合吉西他滨、多西他赛治疗晚期软组织肉瘤的疗效及安全性[J].现代肿瘤医学,2018,26(5):769-772.
[15]胡美琴,高琨.阿帕替尼联合AIM方案治疗晚期软组织肉瘤的临床疗效[J].临床药物治疗杂志,2018,16(4):62-65.
[16]Folkman J,Kalluri R. Cancer without disease[J]. Nature,2004,427(6977):787.
[17]Ellis LM,Hicklin DJ.VEGF-targeted therapy:mechanisms of anti-tumour activity[J]. Nat Rev Cancer,2008,8(8):579-591.
[18]Zhao Y,Adjei AA. Targeting angiogenesis in cancer therapy:moving beyond vascular endothelial growth factor[J].Oncologist,2015,20(6):660-673.
[19]Bertolini F,Marighetti P,Martin-padura I,et al.AntiVEGF and beyond:shaping a new generation of anti-angiogenic therapies for cancer[J]. Drug Discov Today,2011,16(23-24):1052-1060.
[20]Martin-liberal J,Judson I,Benson C. Antiangiogenic approach in soft-tissue sarcomas[J]. Expert Rev Anticancer Ther,2013,13(8):975-982.
[21]Mohindra N,Agulink M. Targeted therapy and promising novel agents for the treatment of advanced soft tissue sarcomas[J]. Expert Opin Investig Drugs,2015,24(11):1409-1418.
[22]Jain RK. Antiangiogenesis strategies revisited:from starving tumors to alleviating hypoxia[J]. Cancer cell,2014,26(5):605-622.
[2]Ducimetiere F,Lurkin A,Ranchere-vince D,et al. Incidence of sarcoma histotypes and molecular subtypes in a prospective epidemiological study with central pathology review and molecular testing[J]. PLoS One,2011,6(8):e20294.
[3]NG VY,Scharschmidt TJ,Mayerson JL,et al. Incidence and survival in sarcoma in the United States:a focus on musculoskeletal lesions[J]. Anticancer Res,2013,33(6):2597-2604.
[4]Kampann E,Altendorf-hofmann A,Gibis S,et al. VEGFR2predicts decreased patients survival in soft tissue sarcomas[J].Pathol Res Pract,2015,211(10):726-730.
[5]Rocchi L,Caraffi S,Perris R,et al. The angiogenic asset of soft tissue sarcomas:a new tool to discover new therapeutic targets[J]. Biosci Rep,2014,34(6):e00147.
[6]Tammela T,Enholm B,Alitalo K,et al. The biology of vascular endothelial growth factors[J]. Cardiovasc Res,2005,65(3):550-563.
[7]Gacche RN,Meshram RJ.Angiogenic factors as potential drug target:efficacy and limitations of anti-angiogenic therapy[J]. Biochim Biophys Acta,2014,1846(1):161-179.
[8]Hensley ML,Miller A,O′malley DM,et al. Randomized phaseⅢtrial of gemcitabine plus docetaxel plus bevacizumab or placebo as first-line treatment for metastatic uterine leiomyosarcoma:an NRG Oncology/Gynecologic Oncology Group study[J]. J Clin Oncol,2015,33(10):1180-1185.
[9]Mir O,Brodowicz T,Italiano A,et al. Safety and efficacy of regorafenib in patients with advanced soft tissue sarcoma(REGOSARC):a randomised,double-blind,placebo-controlled,phase 2 trial[J]. Lancet Oncol,2016,17(12):1732-1742.
[10]Ray-coquard IL,Domont J,Tresch-brunee E,et al. Paclitaxel given once per week with or without bevacizumab in patients with advanced angiosarcoma:a randomized phaseⅡtrial[J]. J Clin Oncol,2015,33(25):2797-2802.
[11]Van Der Graaf WTA,Blay JY,Chawla SP,et al. Pazopanib for metastatic soft-tissue sarcoma(PALETTE):a randomised,double-blind,placebo-controlled phase 3trial[J]. Lancet,2012,379(9829):1879-1886.
[12]Chisholm JC,Merks JHM,Casanova M,et al. Open-label,multicentre,randomised,phaseⅡstudy of the EpSSG and the ITCC evaluating the addition of bevacizumab to chemotherapy in childhood and adolescent patients with metastatic soft tissue sarcoma(the BERNIE study)[J].Eur J Cancer,2017,83(1):77-84.
[13]刘佳勇,樊征夫,李舒,等.盐酸安罗替尼胶囊治疗晚期软组织肉瘤Ⅱb期多中心临床试验的单中心数据分析[J].中国肿瘤临床,2018,45(20):1066-1070.
[14]张殿宝,康议心,郭艳珍.恩度联合吉西他滨、多西他赛治疗晚期软组织肉瘤的疗效及安全性[J].现代肿瘤医学,2018,26(5):769-772.
[15]胡美琴,高琨.阿帕替尼联合AIM方案治疗晚期软组织肉瘤的临床疗效[J].临床药物治疗杂志,2018,16(4):62-65.
[16]Folkman J,Kalluri R. Cancer without disease[J]. Nature,2004,427(6977):787.
[17]Ellis LM,Hicklin DJ.VEGF-targeted therapy:mechanisms of anti-tumour activity[J]. Nat Rev Cancer,2008,8(8):579-591.
[18]Zhao Y,Adjei AA. Targeting angiogenesis in cancer therapy:moving beyond vascular endothelial growth factor[J].Oncologist,2015,20(6):660-673.
[19]Bertolini F,Marighetti P,Martin-padura I,et al.AntiVEGF and beyond:shaping a new generation of anti-angiogenic therapies for cancer[J]. Drug Discov Today,2011,16(23-24):1052-1060.
[20]Martin-liberal J,Judson I,Benson C. Antiangiogenic approach in soft-tissue sarcomas[J]. Expert Rev Anticancer Ther,2013,13(8):975-982.
[21]Mohindra N,Agulink M. Targeted therapy and promising novel agents for the treatment of advanced soft tissue sarcomas[J]. Expert Opin Investig Drugs,2015,24(11):1409-1418.
[22]Jain RK. Antiangiogenesis strategies revisited:from starving tumors to alleviating hypoxia[J]. Cancer cell,2014,26(5):605-622.
© 2004-2018 中国地质图书馆版权所有 京ICP备05064691号 京公网安备11010802017129号 地址：北京市海淀区学院路29号 邮编：100083 电话：办公室：(+86 10)66554848；文献借阅、咨询服务、科技查新：66554700 |