PMID- 37122727
OWN - NLM
STAT- MEDLINE
DCOM- 20230519
LR  - 20230519
IS  - 1664-3224 (Electronic)
IS  - 1664-3224 (Linking)
VI  - 14
DP  - 2023
TI  - The efficacy and safety of anti-PD-1/PD-L1 in treatment of glioma: a single-arm 
      meta-analysis.
PG  - 1168244
LID - 10.3389/fimmu.2023.1168244 [doi]
LID - 1168244
AB  - OBJECTIVE: This meta-analysis aimed to evaluate the efficacy and safety of 
      PD-1/PD-L1 inhibitors in patients with glioma. METHODS: PubMed, EMBASE, Web of 
      Science, and the Cochrane library were searched from inception to January 2023 
      without language restriction. Primary outcomes included overall survival (OS), 
      progression-free survival (PFS), objective response rate (ORR), and adverse 
      events (AEs). The risk of bias was assessed by subgroup analysis, sensitivity 
      analysis, and publication bias, including funnel plot, Egger's test, and Begg's 
      test. RESULTS: A total of 20 studies involving 2,321 patients were included in 
      this meta-analysis. In the analysis of the included phase III clinical trials, 
      the forest plot showed that PD-1/PD-L1 inhibitors did not improve the OS 
      (HR=1.15, 95% CI: 1.03-1.29, P=0.02, I(2) = 14%) and PFS (HR=1.43, 95% CI: 
      1.03-1.99, P=0.03, I(2) = 87%). In the single-arm analysis, the forest plot 
      demonstrated that the 6-month OS was 71% (95% CI: 57%-83%, I(2) = 92%), 1-year OS 
      was 43% (95% CI: 33%-54%, I(2) = 93%), and the 2-year OS was 27% (95% CI: 
      13%-44%, I(2) = 97%). The pooled estimate of the median OS was 8.85 months (95% 
      CI: 7.33-10.36, I(2) = 91%). Furthermore, the result indicated that the 6-month 
      PFS was 28% (95% CI: 18%-40%, I(2) = 95%), 1-year PFS was 15% (95% CI: 8%-23%, 
      I(2) = 92%), and the 18-month PFS was 10% (95% CI: 3%-20%, I(2) = 93%). The 
      pooled estimate of the median PFS was 3.72 months (95% CI: 2.44-5.00, I(2) = 
      99%). For ORR, the pooled estimate of ORR was 10% (95% CI: 2%-20%, I(2) = 88%). 
      We further analyzed the incidence of PD-1/PD-L1 inhibitor-related AEs, and the 
      pooled incidence of AEs was 70% (95% CI: 58%-81%, I(2) = 94%). The incidence of 
      AEs >/= grade 3 was 19% (95% CI: 11%-30%, I(2) = 94%). The funnel plot for the 
      median PFS and median OS was symmetric with no significant differences in Egger's 
      test and Begg's test. The sensitivity analysis revealed that our results were 
      stable and reliable. CONCLUSION: The results of this meta-analysis suggest that 
      anti-PD-1/PD-L1 therapy is relatively safe but could not prolong survival in 
      glioma. More randomized controlled trials are needed to confirm our results. 
      SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/prospero/, identifier 
      CRD42023396057.
CI  - Copyright (c) 2023 Zeng, Wei, Guo, Chen, Deng, Liu, Gong and Zeng.
FAU - Zeng, Yi-Fan
AU  - Zeng YF
AD  - Department of Cardiovascular Surgery, The Second Xiangya Hospital, Central South 
      University, Changsha, Hunan, China.
FAU - Wei, Xin-Yu
AU  - Wei XY
AD  - Department of Pharmacy, Xiangya Hospital, Central South University, Changsha, 
      Hunan, China.
AD  - National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, 
      Central South University, Changsha, Hunan, China.
FAU - Guo, Qi-Hao
AU  - Guo QH
AD  - Department of Pharmacy, Xiangya Hospital, Central South University, Changsha, 
      Hunan, China.
AD  - Department of Pharmacy, Shengjing Hospital of China Medical University, Shenyang, 
      China.
FAU - Chen, Si-Yu
AU  - Chen SY
AD  - Department of Pharmacy, Xiangya Hospital, Central South University, Changsha, 
      Hunan, China.
AD  - National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, 
      Central South University, Changsha, Hunan, China.
FAU - Deng, Sheng
AU  - Deng S
AD  - Department of Pharmacy, Xiangya Hospital, Central South University, Changsha, 
      Hunan, China.
AD  - National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, 
      Central South University, Changsha, Hunan, China.
FAU - Liu, Zheng-Zheng
AU  - Liu ZZ
AD  - Department of Oncology, Xiangya Hospital, Central South University, Changsha, 
      Hunan, China.
FAU - Gong, Zhi-Cheng
AU  - Gong ZC
AD  - Department of Pharmacy, Xiangya Hospital, Central South University, Changsha, 
      Hunan, China.
AD  - National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, 
      Central South University, Changsha, Hunan, China.
FAU - Zeng, Wen-Jing
AU  - Zeng WJ
AD  - Department of Pharmacy, Xiangya Hospital, Central South University, Changsha, 
      Hunan, China.
AD  - National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, 
      Central South University, Changsha, Hunan, China.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
DEP - 20230414
PL  - Switzerland
TA  - Front Immunol
JT  - Frontiers in immunology
JID - 101560960
RN  - 0 (B7-H1 Antigen)
RN  - 0 (Immune Checkpoint Inhibitors)
SB  - IM
MH  - Humans
MH  - *B7-H1 Antigen
MH  - *Glioma/drug therapy
MH  - *Immune Checkpoint Inhibitors/therapeutic use
PMC - PMC10140424
OTO - NOTNLM
OT  - PD- 1/L1
OT  - drug effect evaluation
OT  - drug safety
OT  - glioma
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. The handling editor WC declared a shared parent affiliation 
      with the author Q-HG at the time of review.
EDAT- 2023/05/01 06:42
MHDA- 2023/05/02 06:42
PMCR- 2023/01/01
CRDT- 2023/05/01 03:21
PHST- 2023/02/17 00:00 [received]
PHST- 2023/03/28 00:00 [accepted]
PHST- 2023/05/02 06:42 [medline]
PHST- 2023/05/01 06:42 [pubmed]
PHST- 2023/05/01 03:21 [entrez]
PHST- 2023/01/01 00:00 [pmc-release]
AID - 10.3389/fimmu.2023.1168244 [doi]
PST - epublish
SO  - Front Immunol. 2023 Apr 14;14:1168244. doi: 10.3389/fimmu.2023.1168244. 
      eCollection 2023.