PMID- 38170235
OWN - NLM
STAT- MEDLINE
DCOM- 20240105
LR  - 20240326
IS  - 1432-1335 (Electronic)
IS  - 0171-5216 (Linking)
VI  - 150
IP  - 1
DP  - 2024 Jan 3
TI  - The efficacy of immune checkpoint inhibitors therapy versus chemotherapy in the 
      treatment of advanced and metastatic urothelial carcinoma: a meta-analysis.
PG  - 5
LID - 10.1007/s00432-023-05584-3 [doi]
AB  - PURPOSE: The application of platinum-based chemotherapeutic agents is the 
      traditional treatment paradigm for advanced and metastatic urothelial carcinoma, 
      which has changed with the advent of immune checkpoint inhibitors (ICIs). This 
      study aims to evaluate the efficacy of ICI therapy versus chemotherapy in the 
      treatment of advanced and metastatic urothelial carcinoma. METHODS: A systematic 
      literature search of Web of Science, Embase, PubMed, and Cochrane Central 
      Register of Controlled Trials was performed by two independent investigators. The 
      primary endpoint was overall survival (OS), progression-free survival (PFS), 
      objective response rate (ORR), and adverse events (AEs). RESULTS: The patients 
      treated with ICI monotherapy had no significant difference in OS than those 
      treated with chemotherapy monotherapy (HR: 0.965, 95% CI 0.865-1.076, p = 0.518). 
      However, the patients treated with ICI monotherapy had a higher ORR and lower 
      incidence of high-grade (>/= grade 3) AEs than those treated with chemotherapy 
      monotherapy (OR: 0.568, 95% CI 0.479-0.675, p < 0.001; OR: 0.614, 95% CI 
      0.446-0.845, p = 0.003). The patients treated with ICI in combination with 
      chemotherapy had significantly better OS and PFS than those treated with 
      chemotherapy alone (HR: 0.862, 95% CI 0.776-0.957, p = 0.006; HR: 0.788, 95% CI 
      0.707-0.879, p < 0.001). However, there was no significant difference in ORR or 
      the incidence of grade 3 or higher AEs (OR: 0.951, 95% CI 0.582-1.554, p = 0.841; 
      OR: 0.942, 95% CI 0.836-1.062, p = 0.328). CONCLUSION: ICI monotherapy did not 
      show statistically significant difference in OS but demonstrated higher ORR and 
      lower incidence of high-grade (>/= grade 3) AEs. And a statistically significant OS 
      and PFS benefit was found in patients treated with first-line ICI in combination 
      with chemotherapy compared to chemotherapy alone.
CI  - (c) 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, 
      part of Springer Nature.
FAU - Huang, Gaozhen
AU  - Huang G
AD  - Laboratory of Urology, Department of Urology, Affiliated Hospital of Guangdong 
      Medical University, Zhanjiang, 524001, Guangdong Province, China.
FAU - Xiong, Hong
AU  - Xiong H
AD  - Laboratory of Urology, Department of Urology, Affiliated Hospital of Guangdong 
      Medical University, Zhanjiang, 524001, Guangdong Province, China.
FAU - Li, Shihao
AU  - Li S
AD  - Laboratory of Urology, Department of Urology, Affiliated Hospital of Guangdong 
      Medical University, Zhanjiang, 524001, Guangdong Province, China.
FAU - Zhu, Yi
AU  - Zhu Y
AD  - Laboratory of Urology, Department of Urology, Affiliated Hospital of Guangdong 
      Medical University, Zhanjiang, 524001, Guangdong Province, China.
FAU - Liu, Hongwei
AU  - Liu H
AD  - Laboratory of Urology, Department of Urology, Affiliated Hospital of Guangdong 
      Medical University, Zhanjiang, 524001, Guangdong Province, China. 
      lhwhongwei@gdmu.edu.cn.
LA  - eng
GR  - 2022A1515012195/Natural Science Foundation of Guangdong Province/
GR  - 2020A01022/Zhanjiang Science and Technology Plan Project/
GR  - 2022A01017/Zhanjiang Science and Technology Plan Project/
GR  - 20211221/Research Project of Traditional Chinese Medicine Bureau of Guangdong 
      Province/
GR  - 2022099/Research Project of Traditional Chinese Medicine Bureau of Guangdong 
      Province/
GR  - 20401Z20190003/Research Foundation for Advanced Talents of Affiliated Hospital of 
      Guangdong Medical University/
PT  - Comparative Study
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
DEP - 20240103
PL  - Germany
TA  - J Cancer Res Clin Oncol
JT  - Journal of cancer research and clinical oncology
JID - 7902060
RN  - 0 (Immune Checkpoint Inhibitors)
RN  - 49DFR088MY (Platinum)
SB  - IM
MH  - Humans
MH  - *Carcinoma, Transitional Cell/drug therapy
MH  - Immune Checkpoint Inhibitors/therapeutic use
MH  - Platinum
MH  - Progression-Free Survival
MH  - *Urinary Bladder Neoplasms
OTO - NOTNLM
OT  - Chemotherapy
OT  - Immune checkpoint inhibitors
OT  - Urology
OT  - Urothelial carcinoma
EDAT- 2024/01/04 01:18
MHDA- 2024/01/05 06:42
CRDT- 2024/01/03 12:45
PHST- 2023/10/10 00:00 [received]
PHST- 2023/11/13 00:00 [accepted]
PHST- 2024/01/05 06:42 [medline]
PHST- 2024/01/04 01:18 [pubmed]
PHST- 2024/01/03 12:45 [entrez]
AID - 10.1007/s00432-023-05584-3 [pii]
AID - 10.1007/s00432-023-05584-3 [doi]
PST - epublish
SO  - J Cancer Res Clin Oncol. 2024 Jan 3;150(1):5. doi: 10.1007/s00432-023-05584-3.