Lancet oncol:免疫抑制剂治疗癌症的效果竟也存在“性别歧视”!

2018-05-17 MedSci MedSci原创

虽然现已了解在免疫系统反应中存在性别相关的二重性,但尚不清楚患者性别对免疫关键点抑制剂治疗癌症效果是否有影响。现有研究人员进行一系统回顾和Meta分析来评估免疫关键点抑制剂用于男性和女性的效果异质性。研究人员系统性检索PubMed、MEDLINE、Embase和Scopus数据库中2017年11月30日前发表的免疫关键点抑制剂(PD-1、CTLA-4抑制剂)的随机对照试验,且要求有患者性别区分的死

虽然现已了解在免疫系统反应中存在性别相关的二重性,但尚不清楚患者性别对免疫关键点抑制剂治疗癌症效果是否有影响。现有研究人员进行一系统回顾和Meta分析来评估免疫关键点抑制剂用于男性和女性的效果异质性。

研究人员系统性检索PubMed、MEDLINE、Embase和Scopus数据库中2017年11月30日前发表的免疫关键点抑制剂(PD-1、CTLA-4抑制剂)的随机对照试验,且要求有患者性别区分的死亡危险比(HRs)数据。此外,研究人员还审查了所有主要会议的摘要和报告。排除非随机性试验,只考虑英文文献。主要结点:评估免疫关键点抑制剂用于男性和女性的疗效差异。

筛查了7133个研究,其中20个免疫关键点抑制剂(伊匹单抗、tremelimumab、纳武单抗或派姆单抗)的随机对照试验符合要求。总体上,共有11351位晚期或转移性癌症患者(男性 7646位[67%]、女性 3705位[33%])纳入分析;大部分癌症是黑色素瘤(3632例[32%])和非小细胞肺癌(3482例[31%])。与采用对照治疗的男性相比,免疫抑制剂治疗的男性患者的汇总总体存活HR为0.72(95% CI 0.65-0.79);免疫抑制剂治疗的女性患者的总体存活HR相比对照女性患者的为0.86(95% CI 0.79-0.93)。采用免疫关键点抑制剂治疗的男性和女性之间的疗效差异显著(p=0.0019)。

免疫关键点抑制剂可提高晚期癌症(如黑色素瘤和非小细胞肺癌)患者的总体存活率,但疗效获益大小跟性别相关。未来研究应尽可能让更多女性参与试验,努力提高免疫疗法用于女性患者的效果,或许可探索分别适用于男性和女性的免疫疗法。

原始出处:

Fabio conforti,et al.Cancer immunotherapy efficacy and patients' sex: a systematic review and meta-analysis. The lancet Oncology. May 16,2018.https://doi.org/10.1016/S1470-2045(18)30261-4

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  5. 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objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmhead/Q3auHgzwzM6P57Bs8gOPaY1cQP9lIia0lmZOEXraGaoicqNToIslXDKw/0, createdBy=7a041951742, createdName=衣带渐宽, createdTime=Thu May 17 21:26:11 CST 2018, time=2018-05-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=315985, encodeId=9685315985c5, content=阅读, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/05/13/e51eda1902bf3197b7b2a48e1ba1e39c.jpg, createdBy=6a672335244, createdName=724765917_36481625, createdTime=Thu May 17 12:45:09 CST 2018, time=2018-05-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=315957, encodeId=6cbd31595e7a, content=阅, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/07/a9772c74ffd6edc03a7f9af07b4747f6.jpg, createdBy=b3722138742, createdName=sunfeifeiyang, createdTime=Thu May 17 10:40:18 CST 2018, time=2018-05-17, status=1, ipAttribution=)]
    2018-05-19 Jackie Li

    学习

    0

  6. 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  7. 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  8. 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objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmhead/Q3auHgzwzM6P57Bs8gOPaY1cQP9lIia0lmZOEXraGaoicqNToIslXDKw/0, createdBy=7a041951742, createdName=衣带渐宽, createdTime=Thu May 17 21:26:11 CST 2018, time=2018-05-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=315985, encodeId=9685315985c5, content=阅读, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/05/13/e51eda1902bf3197b7b2a48e1ba1e39c.jpg, createdBy=6a672335244, createdName=724765917_36481625, createdTime=Thu May 17 12:45:09 CST 2018, time=2018-05-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=315957, encodeId=6cbd31595e7a, content=阅, 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    2018-05-17 衣带渐宽

    学习

    0

  9. 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    2018-05-17 724765917_36481625

    阅读

    0

  10. 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    2018-05-17 sunfeifeiyang

    0

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