摘要
目的评价信迪利单抗联合化疗治疗局部晚期/转移性非小细胞肺癌(NSCLC)的有效性、安全性和经济性。方法检索PubMed、Embase、the Cochrane Library、中国期刊全文数据库、万方数据知识服务平台等中英文数据库和卫生技术评估(HTA)相关的网站及数据库,检索时限为数据库建库至2022年12月28日。由2名评价者根据纳入与排除标准独立筛选文献、提取资料及质量评价,并进行定性分析和快速卫生技术评估。结果共纳入系统评价/meta分析4篇,经济学研究4篇。有效性方面,与化疗相比,信迪利单抗联合化疗可提高基因突变阴性的晚期鳞状NSCLC患者以及局部晚期/转移性或复发性非鳞状NSCLC患者的客观缓解率(ORR);亚组分析表明,信迪利单抗联合化疗可提高PD-L1≥50%表达水平患者的无进展生存期(PFS)。安全性方面,对于基因突变阴性的晚期鳞状或局部晚期/转移性非鳞状NSCLC患者,与化疗相比,信迪利单抗联合化疗1~5级治疗相关不良反应、3~5级治疗相关不良反应以及严重不良反应发生率差异无统计学意义。经济性方面,对于未经治疗的晚期鳞状NSCLC患者,与化疗、帕博利珠单抗联合化疗相比,信迪利单抗联合化疗具有较好的经济性;对于未经治疗的局部晚期/转移性或复发性非鳞状NSCLC患者,与卡瑞利珠单抗联合化疗相比,信迪利单抗联合化疗具有较好的经济性。结论信迪利单抗联合化疗一线治疗NSCLC具有良好的有效性、安全性和经济性。
Objective To evaluate the effectiveness,safety and economy of sintilimab combined with chemotherapy for locally advanced or metastatic non-small cell lung cancer(NSCLC).Methods English and Chinese databases such as PubMed,the Cochrane Library,Embase,CNKI,Wanfang Data,and health technology assessment(HTA)related websites and databases were searched.The search time was from the establishment of the database to December 28,2023.Two reviewers independently screened the literatures,extracted the data,assessed the quality and carried out the qualitative analysis and rapid health technology assessment according to the inclusion and exclusion criteria.Results Four systematic reviews and four pharmacoeconomic studies were included.In terms of effectiveness,compared with chemotherapy,sintilimab combined with chemotherapy could improve objective remission rate(ORR)of mutation-negative patients with advanced squamous NSCLC and patients with locally advanced ormetastatic or relapsed non-squamous NSCLC.Subgroup analysis showed that sintilimab combined with chemotherapy could improve progressive-free survival(PFS)in patients with different PD-L1≥50%expression levels.In terms of safety,compared with chemotherapy,for mutation-negative patients with advanced squamous and locally advanced ormetastatic or relapsed non-squamous NSCLC,there were no significanty difference in grade 1 to 5 treatment-related side effects,grade 3 to 5 treatment-related side effects and severe adverse reactions between combined with chemotherapy and chemotherapy.In terms of economy,for patients with advanced squamous NSCLC,compared with chemotherapy and pembrolizumab combined with chemotherapy,sintilimab combined with chemotherapy is cost-effective in China.For patients with locally advanced/metastatic or relapsed non-squamous NSCLC,compared with camrelizumab combined with chemotherapy,sintilimab combined with chemotherapy is also cost-effective in China.Conclusion Sintilimab has favorable efficacy,safety and economy for the first-line treatment of NSCLC.
作者
陈昕怡
赵程程
席庆
CHEN Xin-yi;ZHAO Cheng-cheng;XI Qing(Department of Pharmacy,Aviation General Hospital,Beijing 100012,China)
出处
《临床药物治疗杂志》
2023年第10期69-74,共6页
Clinical Medication Journal
关键词
信迪利单抗
非小细胞肺癌
卫生技术评估
有效性
安全性
经济性
sintilimab
non-small cell lung cancer
health technology assessment
effectiveness
safety
economy
