PMID- 35504202
OWN - NLM
STAT- MEDLINE
DCOM- 20220621
LR  - 20220623
IS  - 1878-1705 (Electronic)
IS  - 1567-5769 (Linking)
VI  - 109
DP  - 2022 Aug
TI  - Efficacy and safety of PD-1 inhibitors combined with chemotherapy as first-line 
      therapy for advanced esophageal cancer: A systematic review and network 
      meta-analysis.
PG  - 108790
LID - S1567-5769(22)00274-0 [pii]
LID - 10.1016/j.intimp.2022.108790 [doi]
AB  - BACKGROUND: Different clinical trials for advanced esophageal cancer have 
      investigated diverse immuno-oncology combinational treatment in first-line 
      setting, but the optimal choice has not been identified. METHODS: We used PubMed, 
      Embase, and Cochrane Library databases for systematic retrieval. The primary 
      endpoint was overall survival (OS), progression-free survival (PFS), objective 
      response rate (ORR) and treatment-related adverse events (AEs) between immune 
      checkpoint inhibitors combined with chemotherapy and chemotherapy. RESULTS: A 
      total of five phase-III randomized controlled trials involving 3,163 patients met 
      the inclusion criteria. Significantly improved OS (HR: 0.69, 95% CI: 0.62-0.76, 
      P＜0.001), PFS (HR: 0.62, 95% CI: 0.55-0.70, P < 0.001) and ORR (RR: 1.41, 95% CI: 
      1.23-1.62, P＜0.001) were observed when programmed death 1 (PD-1) inhibitor was 
      added to chemotherapy. Toripalimab plus chemotherapy achieved the best OS benefit 
      than any other treatment examined (HR: 0.58, 95% CI: 0.43-0.78). The longest PFS 
      was founded in both sintilimab-chemotherapy and camrelizumab-chemotherapy 
      combination (HR: 0.56, 95% CI: 0.46-0.68). Patients treated with 
      nivolumab-chemotherapy got the best ORR improvement as compared to other 
      combinations (RR: 1.73, 95% CI:1.40-2.14). Camrelizumab-chemotherapy and 
      pembrolizumab-chemotherapy caused a relatively lower incidence of grade >/= 3 AEs 
      than other immunotherapy combination regimens. Subgroup analyses suggested 
      significant OS advantage in programmed death-ligand 1(PD-L1) tumor-positive score 
      (TPS) >/= 10% groups and obviously longer PFS in PD-L1 combined positive score 
      (CPS) >/= 10 groups. CONCLUSIONS: In advanced esophageal cancer, PD-1 inhibitors 
      combined with chemotherapy as first-line therapy have better survival outcomes 
      than chemotherapy with greater but manageable toxicity. Toripalimab-chemotherapy 
      showed the best OS benefit over chemotherapy, while sintilimab-chemotherapy and 
      camrelizumab-chemotherapy generated the best PFS. The highest ORR improvement was 
      founded in patients receiving nivolumab plus chemotherapy.
CI  - Copyright (c) 2022 The Author(s). Published by Elsevier B.V. All rights reserved.
FAU - Li, Zi-Chun
AU  - Li ZC
AD  - Department of VIP region, Sun Yat-Sen University Cancer Center, State Key 
      Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer 
      Medicine, 651 Dongfeng Road East, Guangzhou 510060, China.
FAU - Sun, Yu-Ting
AU  - Sun YT
AD  - Department of Medical Oncology, Sun Yat-Sen University Cancer Center, State Key 
      Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer 
      Medicine, 651 Dongfeng Road East, Guangzhou 510060, China.
FAU - Lai, Ming-Yu
AU  - Lai MY
AD  - Department of Medical Oncology, Sun Yat-Sen University Cancer Center, State Key 
      Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer 
      Medicine, 651 Dongfeng Road East, Guangzhou 510060, China.
FAU - Zhou, Yi-Xin
AU  - Zhou YX
AD  - Department of VIP region, Sun Yat-Sen University Cancer Center, State Key 
      Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer 
      Medicine, 651 Dongfeng Road East, Guangzhou 510060, China. Electronic address: 
      zhouyx@sysucc.org.cn.
FAU - Qiu, Miao-Zhen
AU  - Qiu MZ
AD  - Department of Medical Oncology, Sun Yat-Sen University Cancer Center, State Key 
      Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer 
      Medicine, 651 Dongfeng Road East, Guangzhou 510060, China. Electronic address: 
      qiumzh@sysucc.org.cn.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20220430
PL  - Netherlands
TA  - Int Immunopharmacol
JT  - International immunopharmacology
JID - 100965259
RN  - 0 (B7-H1 Antigen)
RN  - 0 (Immune Checkpoint Inhibitors)
RN  - 31YO63LBSN (Nivolumab)
SB  - IM
MH  - B7-H1 Antigen
MH  - Clinical Trials, Phase III as Topic
MH  - *Esophageal Neoplasms/drug therapy
MH  - Humans
MH  - Immune Checkpoint Inhibitors/adverse effects
MH  - *Lung Neoplasms
MH  - Network Meta-Analysis
MH  - Nivolumab
MH  - Randomized Controlled Trials as Topic
OTO - NOTNLM
OT  - Esophageal cancer
OT  - First-line therapy
OT  - Immunotherapy
OT  - Network meta-analysis
OT  - PD-1 inhibitors
EDAT- 2022/05/04 06:00
MHDA- 2022/06/22 06:00
CRDT- 2022/05/03 18:23
PHST- 2022/01/04 00:00 [received]
PHST- 2022/04/14 00:00 [revised]
PHST- 2022/04/18 00:00 [accepted]
PHST- 2022/05/04 06:00 [pubmed]
PHST- 2022/06/22 06:00 [medline]
PHST- 2022/05/03 18:23 [entrez]
AID - S1567-5769(22)00274-0 [pii]
AID - 10.1016/j.intimp.2022.108790 [doi]
PST - ppublish
SO  - Int Immunopharmacol. 2022 Aug;109:108790. doi: 10.1016/j.intimp.2022.108790. Epub 
      2022 Apr 30.