PMID- 38327524
OWN - NLM
STAT- MEDLINE
DCOM- 20240209
LR  - 20240402
IS  - 1664-3224 (Electronic)
IS  - 1664-3224 (Linking)
VI  - 15
DP  - 2024
TI  - Clinical benefit analysis of PD-1 inhibitors in patients with advanced, recurrent 
      or metastatic cervical cancer: a meta-analysis and systematic review.
PG  - 1305810
LID - 10.3389/fimmu.2024.1305810 [doi]
LID - 1305810
AB  - PURPOSE: This study aims to comprehensively evaluate the efficacy and safety of 
      programmed cell death protein-1 (PD-1) in patients with advanced, recurrent, or 
      metastatic cervical cancer (ARMCC) and identify the population that may benefit 
      the most. METHODS: We conducted a search of PubMed, EMBASE, and the Cochrane 
      Collaboration Library from their inception to September 2023. We extracted and 
      analyzed the results related to the efficacy and safety of PD-1 in patients with 
      ARMCC. The primary endpoints included the overall objective response rate (ORR) 
      and adverse events (AEs), while the secondary endpoints encompassed the 1-year 
      overall survival (OS) rate, 1-year progression-free survival (PFS) rate, as well 
      as OS and PFS. We used a random effects model to conduct a meta-analysis on 
      single-group rates, and the Mantel-Haenszel method was utilized to compare the 
      ORR and the incidence of AEs. RESULTS: Our study included a total of 21 trials 
      involving 2,097 patients. The ORR of the combination of PD-1 inhibitors with 
      chemotherapy was 56.36%, the combination of PD-1 inhibitors with anti-angiogenic 
      agents was 38.72%, the combination of PD-1 inhibitors with Cytotoxic T-lymphocyte 
      antigen 4 inhibitors was 25.60%, and PD-1 inhibitor monotherapy was 15.99%. The 
      subgroup analysis showed that the group of patients with squamous cell carcinoma 
      (SCC) exhibited a significantly higher ORR compared to the non-SCC group in 
      patients who received PD-1 inhibitors combined with other anti-tumor drugs (Odds 
      Ratio =2.43, P=0.002). Additionally, the group of patients with a programmed 
      death-ligand 1 combined positive score (PD-L1 CPS) >/=1 exhibited a significantly 
      higher ORR compared to the PD-L1 CPS <1 group in patients who received PD-1 
      inhibitor monotherapy (OR=4.14, P=0.02). PD-1 inhibitor monotherapy or PD-1 
      inhibitors combined with chemotherapy did not significantly increase the 
      incidence of all grades of adverse events (Relative Risk=0.99, p=0.788) or the 
      incidence of serious adverse events (RR=0.99, p=0.788) compared to chemotherapy 
      alone. CONCLUSION: PD-1 inhibitors demonstrate outstanding efficacy in the 
      treatment of patients with ARMCC. Patients with SCC may benefit more from 
      treatments including PD-1 inhibitors in combination with other anti-tumor drugs, 
      and PD-L1 CPS >/=1 can be considered a favorable indicator of immune therapy 
      response. Importantly, the use of PD-1 inhibitor monotherapy or PD-1 inhibitors 
      in combination with chemotherapy did not lead to an increased incidence of AEs 
      compared with chemotherapy alone, indicting safety during treatment. SYSTEMATIC 
      REVIEW REGISTRATION: PROSPERO (CRD42023457945).
CI  - Copyright (c) 2024 Wang, Wang, Du, Tang and Xiao.
FAU - Wang, Yun-Zi
AU  - Wang YZ
AD  - Department of Pathology, Sichuan Science City Hospital, Mianyang, Sichuan, China.
FAU - Wang, Ji-Sheng
AU  - Wang JS
AD  - Department of Pharmacy, The Third Hospital of Mianyang, Sichuan Mental Health 
      Center, Mianyang, Sichuan, China.
FAU - Du, Jiang
AU  - Du J
AD  - Department of General Surgery, Sichuan Science City Hospital, Sichuan, China.
FAU - Tang, Xue-Li
AU  - Tang XL
AD  - Department of Science and Technology, The Third Hospital of Mianyang, Sichuan 
      Mental Health Center, Mianyang, Sichuan, China.
FAU - Xiao, Jing-Ping
AU  - Xiao JP
AD  - Department of Pharmacy, The Third Hospital of Mianyang, Sichuan Mental Health 
      Center, Mianyang, Sichuan, China.
LA  - eng
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20240124
PL  - Switzerland
TA  - Front Immunol
JT  - Frontiers in immunology
JID - 101560960
RN  - 0 (Immune Checkpoint Inhibitors)
RN  - 0 (B7-H1 Antigen)
RN  - 0 (Programmed Cell Death 1 Receptor)
RN  - 0 (Antineoplastic Agents)
SB  - IM
MH  - Humans
MH  - Female
MH  - Immune Checkpoint Inhibitors/adverse effects
MH  - B7-H1 Antigen
MH  - Programmed Cell Death 1 Receptor
MH  - *Uterine Cervical Neoplasms/drug therapy
MH  - *Antineoplastic Agents/therapeutic use
MH  - *Lung Neoplasms/pathology
PMC - PMC10847356
OTO - NOTNLM
OT  - adverse events
OT  - cervical cancer
OT  - combination
OT  - objective response rate
OT  - programmed cell death protein-1
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.
EDAT- 2024/02/08 06:43
MHDA- 2024/02/09 06:43
PMCR- 2024/01/01
CRDT- 2024/02/08 04:05
PHST- 2023/10/02 00:00 [received]
PHST- 2024/01/15 00:00 [accepted]
PHST- 2024/02/09 06:43 [medline]
PHST- 2024/02/08 06:43 [pubmed]
PHST- 2024/02/08 04:05 [entrez]
PHST- 2024/01/01 00:00 [pmc-release]
AID - 10.3389/fimmu.2024.1305810 [doi]
PST - epublish
SO  - Front Immunol. 2024 Jan 24;15:1305810. doi: 10.3389/fimmu.2024.1305810. 
      eCollection 2024.