PMID- 37488978
OWN - NLM
STAT- MEDLINE
DCOM- 20240315
LR  - 20240401
IS  - 1542-6270 (Electronic)
IS  - 1060-0280 (Linking)
VI  - 58
IP  - 4
DP  - 2024 Apr
TI  - Efficacy and Safety of Immune Checkpoint Inhibitors Combined With Chemotherapy as 
      First-line Treatment for Recurrent or Metastatic Nasopharyngeal Carcinoma: A 
      Network Meta-analysis of Randomized Controlled Trials.
PG  - 349-359
LID - 10.1177/10600280231188171 [doi]
AB  - BACKGROUND: Different clinical trials for recurrent or metastatic nasopharyngeal 
      carcinoma have studied different combinations of immuno-oncology in first-line 
      treatment, but the optimal choice has not been determined. OBJECTIVE: To 
      systematically examine and compare the efficacy and safety of different immune 
      checkpoint inhibitors (ICIs) combined with chemotherapy as first-line treatment 
      for recurrent or metastatic nasopharyngeal carcinoma. METHODS: Several electronic 
      databases were systematically searched up to February 2023. Articles meeting the 
      inclusion criteria were included. RESULTS: Three RCTs were eligible in the study. 
      Compared with placebo plus gemcitabine-cisplatin (GP), toripalimab plus GP (HR = 
      0.59, 95% CI: 0.37-0.95) was significantly associated with a better OS. 
      Tislelizumab plus GP generated best progression-free survival (PFS) benefit (HR = 
      0.50, 95% CI: 0.37-0.67), greatest improvement in 1-year PFS rate (RR = 3.00, 95% 
      CI: 1.84-5.22), and objective response rate (ORR) (RR = 1.26, 95% CI: 1.04-1.53) 
      over the placebo plus GP. Furthermore, tislelizumab plus GP appeared to be safer 
      than toripalimab plus GP and camrelizumab plus GP in terms of adverse events 
      (AEs)-grade >/=3, treatment-related AEs (TRAEs)-grade >/=3, serious AEs (SAEs), 
      treatment-related SAEs (TRSAEs), and AEs leading to discontinuation of treatment. 
      CONCLUSION AND RELEVANCE: In recurrent or metastatic nasopharyngeal carcinoma, 
      programmed death 1 (PD-1) inhibitors plus GP as first-line treatment have better 
      survival outcomes than placebo plus GP with comparable toxicity. Toripalimab plus 
      GP shows the best OS benefit over placebo plus GP, while tislelizumab plus GP 
      generates the best PFS, 1-year PFS rate, ORR, and safety. Tislelizumab plus GP 
      could be the best choice among the ICIs combined with chemotherapy regimens as 
      first-line treatment in recurrent or metastatic nasopharyngeal carcinoma.
FAU - Sun, Hong
AU  - Sun H
AUID- ORCID: 0000-0001-9015-0480
AD  - Department of Pharmacy, Eye & ENT Hospital, Fudan University, Shanghai, China.
FAU - Bu, Fengjiao
AU  - Bu F
AD  - Department of Pharmacy, Eye & ENT Hospital, Fudan University, Shanghai, China.
FAU - Li, Ling
AU  - Li L
AD  - Department of Pharmacy, Eye & ENT Hospital, Fudan University, Shanghai, China.
FAU - Zhang, Xiuwen
AU  - Zhang X
AD  - Department of Pharmacy, Eye & ENT Hospital, Fudan University, Shanghai, China.
FAU - Xin, Xiu
AU  - Xin X
AD  - Department of Pharmacy, Eye & ENT Hospital, Fudan University, Shanghai, China.
FAU - Yan, Jingchao
AU  - Yan J
AD  - Department of Pharmacy, Eye & ENT Hospital, Fudan University, Shanghai, China.
FAU - Huang, Taomin
AU  - Huang T
AD  - Department of Pharmacy, Eye & ENT Hospital, Fudan University, Shanghai, China.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20230724
PL  - United States
TA  - Ann Pharmacother
JT  - The Annals of pharmacotherapy
JID - 9203131
RN  - 0 (Immune Checkpoint Inhibitors)
SB  - IM
MH  - Humans
MH  - Antineoplastic Combined Chemotherapy Protocols/adverse effects
MH  - Immune Checkpoint Inhibitors/adverse effects
MH  - *Lung Neoplasms/drug therapy
MH  - Nasopharyngeal Carcinoma/drug therapy/etiology
MH  - *Nasopharyngeal Neoplasms/drug therapy/etiology/pathology
MH  - Network Meta-Analysis
MH  - Randomized Controlled Trials as Topic
OTO - NOTNLM
OT  - PD-1 inhibitor
OT  - efficacy
OT  - immune checkpoint inhibitor
OT  - nasopharyngeal carcinoma
OT  - network meta-analysis
OT  - safety
COIS- Declaration of Conflicting InterestsThe authors declared no potential conflicts 
      of interest with respect to the research, authorship, and/or publication of this 
      article.
EDAT- 2023/07/25 06:43
MHDA- 2024/03/15 06:44
CRDT- 2023/07/25 02:17
PHST- 2024/03/15 06:44 [medline]
PHST- 2023/07/25 06:43 [pubmed]
PHST- 2023/07/25 02:17 [entrez]
AID - 10.1177/10600280231188171 [doi]
PST - ppublish
SO  - Ann Pharmacother. 2024 Apr;58(4):349-359. doi: 10.1177/10600280231188171. Epub 
      2023 Jul 24.