Impact of programmed cell death protein 1 inhibitor therapy on the survival of patients with advanced or recurrent uterine cancers: a meta-analysis
IntroductionNo prior meta-analysis has investigated the impact of programmed cell death protein 1 (PD-1) inhibitor therapy on survival outcomes in patients with advanced or recurrent uterine cancers (including both corpus and cervical cancers).MethodsA comprehensive search of PubMed and Embase datab...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2024-03-01
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| Series: | Frontiers in Immunology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fimmu.2024.1331994/full |
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| author | Keng-Wei Liang Keng-Wei Liang Liang-Jou Chen Chun-Hao Wang Kevin Sheng-Kai Ma Kevin Sheng-Kai Ma Kevin Sheng-Kai Ma Li-Hsin Hsia Po-Hui Wang Po-Hui Wang |
| author_facet | Keng-Wei Liang Keng-Wei Liang Liang-Jou Chen Chun-Hao Wang Kevin Sheng-Kai Ma Kevin Sheng-Kai Ma Kevin Sheng-Kai Ma Li-Hsin Hsia Po-Hui Wang Po-Hui Wang |
| author_sort | Keng-Wei Liang |
| collection | DOAJ |
| description | IntroductionNo prior meta-analysis has investigated the impact of programmed cell death protein 1 (PD-1) inhibitor therapy on survival outcomes in patients with advanced or recurrent uterine cancers (including both corpus and cervical cancers).MethodsA comprehensive search of PubMed and Embase databases was conducted, covering the past 10 years (up to August 2023) and encompassing all clinical research related to uterine cancer. Five randomized controlled trials and one cohort study met the inclusion criteria and were included in the meta-analysis. Data on patient demographics, clinical characteristics, treatment regimens, and survival outcomes were extracted. Hazard ratios (HRs) for overall survival (OS) and progression-free survival (PFS), as well as the relative risk of grade 3 or higher adverse events, were pooled using random-effects models.ResultsPatients receiving PD-1 inhibitors had better OS (HR, 0.65, 95% CI, 0.59–0.72; P<.001) and PFS (HR, 0.59, 95% CI, 0.49–0.70; P<.001) than those receiving variable non-PD-1 inhibitor therapies among 3452 uterine cancer patients. The leave-one-out meta-analysis of the HR of OS showed no individual study impact on the estimation of the overall effect size. Subgroup analysis revealed better OS in the PD-1 inhibitors use than the controls in cervical cancer (HR, 0.68, 95% CI, 0.59–0.79), endometrial cancer (HR, 0.62, 95% CI, 0.54-0.72), and pembrolizumab use (HR, 0.66, 95% CI, 0.57–0.75) subgroups. Patients with advanced cervical cancer, who had CPS > 1, receiving PD-1 inhibitors have statistically significant benefits in OS compared to controls (HR, 0.65, 95% CI, 0.53-0.80). The pooled HR for overall survival was 0.71 (95% CI, 0.60-0.82; P<.001) in patients who received PD-1 inhibitors as compared to those who did not receive PD-1 inhibitors in proficient mismatch repair (MMR) endometrial cancer patients. However, in deficient MMR patients, the HR was 0.30 (95% CI, 0.13-0.70). The relative risk of grade 3 or higher adverse events was not higher in the PD-1 inhibitor group (relative risk, 1.12, 95% CI, 0.98–1.27).ConclusionSurvival was significantly better using PD-1 inhibitor therapy than variable non-PD-1 inhibitor chemotherapies among patients with advanced or recurrent uterine cancers. |
| first_indexed | 2024-04-24T22:57:46Z |
| format | Article |
| id | doaj.art-19d795d4ddfa4c8c96a45298c3c87ed4 |
| institution | Directory Open Access Journal |
| issn | 1664-3224 |
| language | English |
| last_indexed | 2024-04-24T22:57:46Z |
| publishDate | 2024-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Immunology |
| spelling | doaj.art-19d795d4ddfa4c8c96a45298c3c87ed42024-03-18T04:25:30ZengFrontiers Media S.A.Frontiers in Immunology1664-32242024-03-011510.3389/fimmu.2024.13319941331994Impact of programmed cell death protein 1 inhibitor therapy on the survival of patients with advanced or recurrent uterine cancers: a meta-analysisKeng-Wei Liang0Keng-Wei Liang1Liang-Jou Chen2Chun-Hao Wang3Kevin Sheng-Kai Ma4Kevin Sheng-Kai Ma5Kevin Sheng-Kai Ma6Li-Hsin Hsia7Po-Hui Wang8Po-Hui Wang9Institute of Medicine and School of Medicine, Chung Shan Medical University, Taichung, TaiwanDepartment of Medical Imaging, Chung Shan Medical University Hospital, Taichung, TaiwanSchool of Medicine, Kaohsiung Medical University, Kaohsiung, TaiwanDepartment of Medicine, National Taiwan University, Taipei, TaiwanDepartment of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United StatesCenter for Global Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United StatesDivision of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United StatesDepartment of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, TaiwanInstitute of Medicine and School of Medicine, Chung Shan Medical University, Taichung, TaiwanDepartment of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, TaiwanIntroductionNo prior meta-analysis has investigated the impact of programmed cell death protein 1 (PD-1) inhibitor therapy on survival outcomes in patients with advanced or recurrent uterine cancers (including both corpus and cervical cancers).MethodsA comprehensive search of PubMed and Embase databases was conducted, covering the past 10 years (up to August 2023) and encompassing all clinical research related to uterine cancer. Five randomized controlled trials and one cohort study met the inclusion criteria and were included in the meta-analysis. Data on patient demographics, clinical characteristics, treatment regimens, and survival outcomes were extracted. Hazard ratios (HRs) for overall survival (OS) and progression-free survival (PFS), as well as the relative risk of grade 3 or higher adverse events, were pooled using random-effects models.ResultsPatients receiving PD-1 inhibitors had better OS (HR, 0.65, 95% CI, 0.59–0.72; P<.001) and PFS (HR, 0.59, 95% CI, 0.49–0.70; P<.001) than those receiving variable non-PD-1 inhibitor therapies among 3452 uterine cancer patients. The leave-one-out meta-analysis of the HR of OS showed no individual study impact on the estimation of the overall effect size. Subgroup analysis revealed better OS in the PD-1 inhibitors use than the controls in cervical cancer (HR, 0.68, 95% CI, 0.59–0.79), endometrial cancer (HR, 0.62, 95% CI, 0.54-0.72), and pembrolizumab use (HR, 0.66, 95% CI, 0.57–0.75) subgroups. Patients with advanced cervical cancer, who had CPS > 1, receiving PD-1 inhibitors have statistically significant benefits in OS compared to controls (HR, 0.65, 95% CI, 0.53-0.80). The pooled HR for overall survival was 0.71 (95% CI, 0.60-0.82; P<.001) in patients who received PD-1 inhibitors as compared to those who did not receive PD-1 inhibitors in proficient mismatch repair (MMR) endometrial cancer patients. However, in deficient MMR patients, the HR was 0.30 (95% CI, 0.13-0.70). The relative risk of grade 3 or higher adverse events was not higher in the PD-1 inhibitor group (relative risk, 1.12, 95% CI, 0.98–1.27).ConclusionSurvival was significantly better using PD-1 inhibitor therapy than variable non-PD-1 inhibitor chemotherapies among patients with advanced or recurrent uterine cancers.https://www.frontiersin.org/articles/10.3389/fimmu.2024.1331994/fulluterine cancerPD-1 inhibitorssurvivaladverse eventsmeta-analysis |
| spellingShingle | Keng-Wei Liang Keng-Wei Liang Liang-Jou Chen Chun-Hao Wang Kevin Sheng-Kai Ma Kevin Sheng-Kai Ma Kevin Sheng-Kai Ma Li-Hsin Hsia Po-Hui Wang Po-Hui Wang Impact of programmed cell death protein 1 inhibitor therapy on the survival of patients with advanced or recurrent uterine cancers: a meta-analysis Frontiers in Immunology uterine cancer PD-1 inhibitors survival adverse events meta-analysis |
| title | Impact of programmed cell death protein 1 inhibitor therapy on the survival of patients with advanced or recurrent uterine cancers: a meta-analysis |
| title_full | Impact of programmed cell death protein 1 inhibitor therapy on the survival of patients with advanced or recurrent uterine cancers: a meta-analysis |
| title_fullStr | Impact of programmed cell death protein 1 inhibitor therapy on the survival of patients with advanced or recurrent uterine cancers: a meta-analysis |
| title_full_unstemmed | Impact of programmed cell death protein 1 inhibitor therapy on the survival of patients with advanced or recurrent uterine cancers: a meta-analysis |
| title_short | Impact of programmed cell death protein 1 inhibitor therapy on the survival of patients with advanced or recurrent uterine cancers: a meta-analysis |
| title_sort | impact of programmed cell death protein 1 inhibitor therapy on the survival of patients with advanced or recurrent uterine cancers a meta analysis |
| topic | uterine cancer PD-1 inhibitors survival adverse events meta-analysis |
| url | https://www.frontiersin.org/articles/10.3389/fimmu.2024.1331994/full |
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