PMID- 35309350
OWN - NLM
STAT- MEDLINE
DCOM- 20220502
LR  - 20220502
IS  - 1664-3224 (Electronic)
IS  - 1664-3224 (Linking)
VI  - 13
DP  - 2022
TI  - Efficacy and Safety of Anti-PD1/PDL1 in Advanced Biliary Tract Cancer: A 
      Systematic Review and Meta-Analysis.
PG  - 801909
LID - 10.3389/fimmu.2022.801909 [doi]
LID - 801909
AB  - BACKGROUND: Anti-programmed cell death protein 1 and its ligand (anti-PD1/PDL1) 
      have been proposed as a promising therapeutic option for advanced biliary tract 
      cancer (aBTC). Given the scarce quantitative analyses of anti-PD1/PDL1 in aBTC, 
      we thus did a meta-analysis to assess the benefits and risks of this emerging 
      treatment strategy in patients with aBTC. METHODS: PubMed, Embase, the Cochrane 
      Library, Web of Science, and meeting resources were searched for relevant 
      studies. The main endpoints were median progression-free survival (mPFS), median 
      overall survival (mOS), objective response rate (ORR), disease control rate 
      (DCR), any-grade adverse events (AEs), and grade 3-4 AEs. RESULTS: Twenty-eight 
      studies with 1,338 participants were included. The best curative effect was found 
      in the anti-PD1/PDL1 combined with anti-CTLA4 and chemotherapy group (mPFS: 
      12.4 months; mOS: 16.0 months; ORR: 45.1%; DCR: 95.0%), followed by the 
      anti-PD1/PDL1 plus chemotherapy group (mPFS: 8.2 months; mOS: 14.8 months; ORR: 
      36.3%; DCR: 84.6%), the anti-PD1/PDL1 plus antiangiogenesis group (mPFS: 
      4.9 months; mOS: 10.2 months; ORR: 17.5%; DCR: 68.7%), the anti-PD1/PDL1 plus 
      anti-cytotoxic T lymphocyte antigen 4 (anti-CTLA4) group (mPFS: 2.9 months; mOS: 
      8.3 months; ORR: 9.9%; DCR: 36.8%), and the anti-PD1/PDL1 monotherapy group 
      (mPFS: 2.5 months; mOS: 7.6 months; ORR: 6.8%; DCR: 34.7%). Compared with 
      anti-PD1-containing regimens, anti-PDL1-containing regimens achieved preferable 
      mPFS (11.1 vs. 3.8 months), mOS (12.2 vs. 9.8 months), and ORR (23.7% vs. 17.4%), 
      despite a similar DCR (61.1% vs. 61.3%). The mPFS, mOS, ORR, and DCR were 
      10.6 months, 15.8 months, 42.3%, and 88.6% of first-line anti-PD1/PDL1 and 
      3.0 months, 9.1 months, 11.6%, and 51.1% of second-line therapy or beyond, 
      respectively. There were 80.6% and 34.0% of the patients suffering any-grade AEs 
      and grade 3-4 AEs. Anti-PD1/PDL1 monotherapy might be considered as a safer 
      alternative than combination regimens. Meanwhile, obvious toxicities in the 
      first-line setting could not be neglected. CONCLUSIONS: Anti-PD1/PDL1 showed 
      encouraging efficacy and acceptable safety profile in aBTC and, thus, could be an 
      alternative treatment.
CI  - Copyright (c) 2022 Jiang, Huang, Zhang, Li, Chen, Cui, Li and Guo.
FAU - Jiang, Qi
AU  - Jiang Q
AD  - VIP Department, Sun Yat-sen University Cancer Center, Guangzhou, China.
AD  - State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer 
      Center, Guangzhou, China.
AD  - Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University 
      Cancer Center, Guangzhou, China.
FAU - Huang, Jinsheng
AU  - Huang J
AD  - VIP Department, Sun Yat-sen University Cancer Center, Guangzhou, China.
AD  - State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer 
      Center, Guangzhou, China.
AD  - Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University 
      Cancer Center, Guangzhou, China.
FAU - Zhang, Bei
AU  - Zhang B
AD  - VIP Department, Sun Yat-sen University Cancer Center, Guangzhou, China.
AD  - State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer 
      Center, Guangzhou, China.
AD  - Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University 
      Cancer Center, Guangzhou, China.
FAU - Li, Xujia
AU  - Li X
AD  - VIP Department, Sun Yat-sen University Cancer Center, Guangzhou, China.
AD  - State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer 
      Center, Guangzhou, China.
AD  - Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University 
      Cancer Center, Guangzhou, China.
FAU - Chen, Xiuxing
AU  - Chen X
AD  - Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene 
      Regulation, Department of Medical Oncology, Sun Yat-sen Memorial Hospital, Sun 
      Yat-sen University, Guangzhou, China.
FAU - Cui, Bokang
AU  - Cui B
AD  - State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer 
      Center, Guangzhou, China.
AD  - Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University 
      Cancer Center, Guangzhou, China.
AD  - Department of Pancreaticobiliary Surgery, Sun Yat-sen University Cancer Center, 
      Guangzhou, China.
FAU - Li, Shengping
AU  - Li S
AD  - State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer 
      Center, Guangzhou, China.
AD  - Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University 
      Cancer Center, Guangzhou, China.
AD  - Department of Pancreaticobiliary Surgery, Sun Yat-sen University Cancer Center, 
      Guangzhou, China.
FAU - Guo, Guifang
AU  - Guo G
AD  - VIP Department, Sun Yat-sen University Cancer Center, Guangzhou, China.
AD  - State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer 
      Center, Guangzhou, China.
AD  - Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University 
      Cancer Center, Guangzhou, China.
LA  - eng
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
PT  - Systematic Review
DEP - 20220302
PL  - Switzerland
TA  - Front Immunol
JT  - Frontiers in immunology
JID - 101560960
RN  - 0 (Antibodies, Monoclonal, Humanized)
RN  - 52CMI0WC3Y (atezolizumab)
SB  - IM
MH  - Antibodies, Monoclonal, Humanized/therapeutic use
MH  - *Antineoplastic Combined Chemotherapy Protocols/therapeutic use
MH  - *Biliary Tract Neoplasms/drug therapy
MH  - Humans
MH  - Progression-Free Survival
PMC - PMC8924050
OTO - NOTNLM
OT  - anti-CTLA4
OT  - anti-PD1
OT  - anti-PDL1
OT  - antiangiogenesis
OT  - biliary tract cancer (BTC)
OT  - chemotherapy
OT  - meta-analysis
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2022/03/22 06:00
MHDA- 2022/05/03 06:00
PMCR- 2022/01/01
CRDT- 2022/03/21 08:50
PHST- 2021/10/26 00:00 [received]
PHST- 2022/02/03 00:00 [accepted]
PHST- 2022/03/21 08:50 [entrez]
PHST- 2022/03/22 06:00 [pubmed]
PHST- 2022/05/03 06:00 [medline]
PHST- 2022/01/01 00:00 [pmc-release]
AID - 10.3389/fimmu.2022.801909 [doi]
PST - epublish
SO  - Front Immunol. 2022 Mar 2;13:801909. doi: 10.3389/fimmu.2022.801909. eCollection 
      2022.