PMID- 37627060
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230828
IS  - 2072-6694 (Print)
IS  - 2072-6694 (Electronic)
IS  - 2072-6694 (Linking)
VI  - 15
IP  - 16
DP  - 2023 Aug 9
TI  - Efficacy and Safety of PD-1/PD-L1 Inhibitor as Single-Agent Immunotherapy in 
      Endometrial Cancer: A Systematic Review and Meta-Analysis.
LID - 10.3390/cancers15164032 [doi]
LID - 4032
AB  - The programmed cell death protein 1 (PD-1)/programmed cell death ligand 1 (PD-L1) 
      pathway plays a crucial role in the immune escape mechanism and growth of cancer 
      cells in endometrial cancer (EC). Clinical trials investigating PD-1/PD-L1 
      inhibitor have shown promising results in other cancers, but their efficacy in EC 
      still remains uncertain. Therefore, this meta-analysis aims to provide an updated 
      and robust analysis of the effectiveness and safety of PD-1/PDL1 inhibitor as 
      single-agent immunotherapy in EC, focusing on the objective response rate (ORR), 
      disease control rate (DCR), and adverse events (AEs). This meta-analysis utilized 
      STATA version 17 and RevMan version 5.4 software to pool the results of relevant 
      studies. Five studies conducted between 2017 and 2022, comprising a total of 480 
      EC patients enrolled for PD-1/PD-L1 inhibitor immunotherapy met the inclusion 
      criteria. The pooled proportion of EC patients who achieved ORR through 
      PD-1/PD-L1 inhibitor treatment was 26.0% (95% CI: 16.0-36.0%; p < 0.05). Subgroup 
      analysis based on mismatch repair (MMR) status showed an ORR of 44.0% (95% CI: 
      38.0-50.0%; p = 0.32) for the deficient mismatch repair (dMMR) group and 8.0% 
      (95% CI: 0.0-16.0%; p = 0.07) for the proficient mismatch repair (pMMR) group. 
      Pooled proportion analysis by DCR demonstrated an odds ratio (OR) of 41.0% (95% 
      CI: 36.0-46.0%, p = 0.83) for patients undergoing PD-1/PD-L1 inhibitor treatment. 
      Subgroup analysis based on MMR status revealed DCR of 54.0% (95% CI: 47.0-62.0%; 
      p = 0.83) for the dMMR group, and 31.0% (95% CI: 25.0-39.0%; p = 0.14) for the 
      pMMR group. The efficacy of PD-1/PD-L1 inhibitors was significantly higher in the 
      dMMR group compared to the pMMR group, in terms of both ORR (OR = 6.30; 95% CI = 
      3.60-11.03; p < 0.05) and DCR (OR = 2.57; 95% CI = 1.66-3.99; p < 0.05). In terms 
      of safety issues, the pooled proportion of patients experiencing at least one 
      adverse event was 69.0% (95% CI: 65.0-73.0%; p > 0.05), with grade three or 
      higher AEs occurring in 16.0% of cases (95% CI: 12.0-19.0%; p > 0.05). Based on 
      the subgroup analysis of MMR status, PD-1/PD-L1 inhibitor immunotherapy showed 
      significantly better efficacy among dMMR patients. These findings suggest that 
      patients with dMMR status may be more suitable for this treatment approach. 
      However, further research on PD-1/PD-L1 inhibitor immunotherapy strategies is 
      needed to fully explore their potential and improve treatment outcomes in EC.
FAU - Mamat Yusof, Mohd Nazzary
AU  - Mamat Yusof MN
AUID- ORCID: 0000-0002-3331-0262
AD  - Gynaecologic-Oncology Unit, Department of Obstetrics and Gynaecology, Hospital 
      Canselor Tuanku Muhriz, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur 
      56000, Malaysia.
FAU - Chew, Kah Teik
AU  - Chew KT
AUID- ORCID: 0000-0002-6542-386X
AD  - Gynaecologic-Oncology Unit, Department of Obstetrics and Gynaecology, Hospital 
      Canselor Tuanku Muhriz, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur 
      56000, Malaysia.
FAU - Hafizz, Abdul Muzhill Hannaan Abdul
AU  - Hafizz AMHA
AD  - Gynaecologic-Oncology Unit, Department of Obstetrics and Gynaecology, Hospital 
      Canselor Tuanku Muhriz, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur 
      56000, Malaysia.
FAU - Abd Azman, Siti Hajar
AU  - Abd Azman SH
AD  - Department of Obstetrics and Gynaecology, Faculty of Medicine, Universiti 
      Kebangsaan Malaysia, Cheras, Kuala Lumpur 56000, Malaysia.
FAU - Ab Razak, Wira Sofran
AU  - Ab Razak WS
AD  - Department of Obstetrics and Gynaecology, Faculty of Medicine, Universiti 
      Kebangsaan Malaysia, Cheras, Kuala Lumpur 56000, Malaysia.
FAU - Hamizan, Muhammad Rafi'uddin
AU  - Hamizan MR
AD  - Department of Obstetrics and Gynaecology, Faculty of Medicine, Universiti 
      Kebangsaan Malaysia, Cheras, Kuala Lumpur 56000, Malaysia.
FAU - Kampan, Nirmala Chandralega
AU  - Kampan NC
AUID- ORCID: 0000-0003-1417-192X
AD  - Gynaecologic-Oncology Unit, Department of Obstetrics and Gynaecology, Hospital 
      Canselor Tuanku Muhriz, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur 
      56000, Malaysia.
FAU - Shafiee, Mohamad Nasir
AU  - Shafiee MN
AD  - Gynaecologic-Oncology Unit, Department of Obstetrics and Gynaecology, Hospital 
      Canselor Tuanku Muhriz, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur 
      56000, Malaysia.
LA  - eng
GR  - FRGS/1/2020/SKK0/UKM/03/2/Fundamental Research Grant Scheme by the Ministry of 
      Higher Education Malaysia/
PT  - Journal Article
PT  - Review
DEP - 20230809
PL  - Switzerland
TA  - Cancers (Basel)
JT  - Cancers
JID - 101526829
PMC - PMC10452317
OTO - NOTNLM
OT  - adverse events
OT  - clinical trials efficacy
OT  - endometrial cancer
OT  - immune checkpoint inhibitor
OT  - mismatch repair
OT  - programmed cell death ligand 1
OT  - programmed cell death ligand 2
OT  - programmed cell death protein 1
COIS- The authors declare no conflict of interest.
EDAT- 2023/08/26 10:42
MHDA- 2023/08/26 10:43
PMCR- 2023/08/09
CRDT- 2023/08/26 01:03
PHST- 2023/06/28 00:00 [received]
PHST- 2023/07/28 00:00 [revised]
PHST- 2023/08/03 00:00 [accepted]
PHST- 2023/08/26 10:43 [medline]
PHST- 2023/08/26 10:42 [pubmed]
PHST- 2023/08/26 01:03 [entrez]
PHST- 2023/08/09 00:00 [pmc-release]
AID - cancers15164032 [pii]
AID - cancers-15-04032 [pii]
AID - 10.3390/cancers15164032 [doi]
PST - epublish
SO  - Cancers (Basel). 2023 Aug 9;15(16):4032. doi: 10.3390/cancers15164032.