A Meta-analysis of the Efficacy and Safety of Camrelizumab Combined with Chemotherapy in the Treatment of Non-small Cell Lung Cancer

Caini ZHANG; Ya LI

doi:10.12259/j.issn.2095-610X.S20240610

Volume 45 Issue 6

Jul. 2024

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Caini ZHANG, Ya LI. A Meta-analysis of the Efficacy and Safety of Camrelizumab Combined with Chemotherapy in the Treatment of Non-small Cell Lung Cancer[J]. Journal of Kunming Medical University, 2024, 45(6): 75-84. doi: 10.12259/j.issn.2095-610X.S20240610

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Caini ZHANG, Ya LI. A Meta-analysis of the Efficacy and Safety of Camrelizumab Combined with Chemotherapy in the Treatment of Non-small Cell Lung Cancer[J]. Journal of Kunming Medical University, 2024, 45(6): 75-84. doi: 10.12259/j.issn.2095-610X.S20240610

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A Meta-analysis of the Efficacy and Safety of Camrelizumab Combined with Chemotherapy in the Treatment of Non-small Cell Lung Cancer

doi: 10.12259/j.issn.2095-610X.S20240610

Caini ZHANG^{1, 2, 3},
Ya LI^{1, 2, 3
,
,}

1.
Department of Clinical Laboratory，The 1st Affiliated Hospital of Kunming Medical University，Kunming Yunnan 650032
2.
Yunnan Key Laboratory of Laboratory Medicine，Kunming Yunnan 650032
3.
Yunnan Province Clinical Research Center for Laboratory Medicine，Kunming Yunnan 650032，China

Received Date: 2024-02-28
Available Online: 2024-05-24
Publish Date: 2024-06-25

Abstract

Abstract

Objective To discuss the difference in efficacy and safety of immune checkpoint inhibitor camrelizumab alone and combined chemotherapy in the treatment of non-small cell lung cancer. Aggregate analysis of multiple clinical trial data was conducted to obtain more accurate efficacy and safety evaluation, and bring effective information and medication guidance to clinical patients. Methods By searching PubMed, Embase, Cochrane Library, CBM database, CNKI, VIP Chinese database and Wanfang database, we collected the required randomized controlled trials or non-randomized controlled trials published until November 30, 2023. After data extraction, Revman5.4 software was applied for data analysis. According to the different treatment plan, the study subjects were divided into camrelizumab combined chemotherapy group and chemotherapy group alone for research discussion. Results A total of 19 articles were included, with a total of 1545 patients. Meta results showed: compared with chemotherapy alone, camrelizumab combined with chemotherapy in the treatment of non-small lung cancer was more effective in improving the overall response rate （OR = 2.50, 95%CI:2.02～3.08, P < 0.00001）, increased the CD4⁺/CD8⁺ ratio （MD = 0.26, 95%CI:0.19～0.33, P < 0.00001） and effectively reduced the serum tumor marker CA125 （MD = -10.65, 95%CI:-14.34～-6.96, P < 0.00001） and CEA （MD = 5.56, 95%CI:-7.64～-3.47, P < 0.00001）, CY211 （MD = -2.17, 95%CI:-3.22～1.13, P = 0.00001）. Different adverse reactions showed different cluster analysis results. Among them, camrelizumab combined chemotherapy increased anemia （OR = 1.95, 95%CI:1.09～3.51, P = 0.03）, hypothyroidism （OR = 5.61, 95%CI:1.82～17.25, P = 0.003） and capillary hyperplasia （OR = 2.86, 95%CI:1.19～6.88, P = 0.02） compared with chemotherapy alone, P values were all < 0.05, and the difference was statistically significant. However, rash （OR = 1.34, 95%CI:0.82～2.16, P = 0.24）, myelosuppression （OR = 1.06, 95%CI:0.56～2.02, P = 0.86）, leukopenia （OR = 0.78, 95%CI:0.40～1.52, P = 0.47）, alopecia （OR = 1.29, 95%CI:0.57～2.92, P = 0.54）, neurological abnormalities （OR = 1.17, 95%CI:0.39～3.56, P = 0.78）, digestive tract abnormalities （OR = 1.10, 95%CI:0.79～1.53, P = 0.57）, liver function abnormalities （OR = 1.54, 95%CI:0.92～2.59, P = 0.10）, nausea and vomiting （OR = 1.16, 95%CI:0.58～2.31, P = 0.67）, coughing up blood （OR = 0.87, 95%CI:0.30～2.49, P = 0.79）, fever（OR = 1.22, 95%CI:0.65～2.30, P = 0.54） and others （OR = 1.32, 95%CI:0.76～2.31, P = 0.32） had no significant change in the incidence of symptoms, and all P values were greater than 0.05, the difference was not statistically significant. Taking into account the incidence of all kinds of adverse reactions mentioned above, in general, camrelizumab combined chemotherapy did not increase the incidence of adverse reactions compared with chemotherapy alone （OR = 1.32, 95%CI:1.13～1.55, P = 0.23）, with a P value greater than 0.05, and the difference was not statistically significant. Conclusion Compared with chemotherapy alone, camrelizumab combined chemotherapy can more effectively improve the overall response rate and CD4⁺/CD8⁺ ratio in patients with non-small cell lung cancer, reduce the absolute value of serum tumor markers, and does not increase the incidence of adverse reactions, with good safety.
- Camrelizumab,
- Non-small cell lung cancer,
- Combination therapy,
- Chemotherapy,
- Meta-analysis,
- PD-1 inhibitors

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References(29)

References

[1]	Sung H,Ferlay J,Siegel R L,et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin,2021,71(3):209-249.
[2]	Chen P,Liu Y,Wen Y,et al. Non-small cell lung cancer in China[J]. Cancer Commun (Lond),2022,42(10):937-970.
[3]	Brahmer J R,Pardoll D M. Immune checkpoint inhibitors: Making immunotherapy a reality for the treatment of lung cancer[J]. Cancer Immunol Res,2013,1(2):85-91.
[4]	Markham A,Keam S J. Camrelizumab: First Global Approval[J]. Drugs,2019,79(12):1355-1361.
[5]	殷秋芳, 罗雯斌, 李春儿. 不同病理和生理特征非小细胞肺癌患者组织和血液中miR-21表达量的Meta分析[J]. 中国卫生检验杂志,2023,33(19):2382-2384,2388.
[6]	蔡思敏,胡巍,袁云. 卡瑞利珠单抗联合PC化疗方案对晚期非小细胞肺癌患者血清肿瘤标志物的影响[J]. 药品评价,2022,19(16):993-996.
[7]	龚关,林祝贤,林锦琛. 卡瑞利珠单抗联合紫杉醇、卡铂化疗对晚期非小细胞肺癌的疗效[J]. 中外医学研究,2023,21(19):149-152.
[8]	谷雨,许斌. 卡瑞利珠单抗联合培美曲塞及顺铂化疗治疗晚期非小细胞肺癌患者的临床疗效研究[J]. 反射疗法与康复医学,2023,4(2):113-116.
[9]	韩璐,厉锋. 卡瑞利珠单抗联合化疗治疗晚期NSCLC患者的治疗效果[J]. 分子诊断与治疗杂志,2022,14(10):1692-1695,1700.
[10]	侯晓杰. 免疫治疗药物对非小细胞肺癌的有效性和安全性研究[J]. 医学信息,2022,35(18):118-120.
[11]	李林. 卡瑞利珠单抗联合化疗治疗晚期非小细胞肺癌的临床疗效及安全性观察[J]. 中文科技期刊数据库(全文版)医药卫生,2022,(7):8-11.
[12]	梁平红,周建军. 卡瑞利珠单抗联合化疗治疗晚期非小细胞肺癌效果观察[J]. 现代养生,2023,23(4):257-259. doi: 10.3969/j.issn.1671-0223(s).2023.04.005
[13]	刘艳,段爱雄,高艳,等. 卡瑞利珠单抗联合化疗治疗晚期非小细胞肺癌的临床疗效及安全性观察[J]. 中国医院用药评价与分析,2021,21(10):1169-1172.
[14]	彭赖水,黎平康. 免疫治疗应用于晚期非小细胞肺癌的效果与安全性分析[J]. 现代医学与健康研究电子杂志,2023,7(12):1-3.
[15]	汪淼,马桂香,丁雷,等. 卡瑞利珠单抗联合化疗治疗中晚期非小细胞肺癌的临床研究[J]. 中文科技期刊数据库(全文版)医药卫生,2022,(3):85-87.
[16]	王守华,蒋从飞,刘平. TP方案联合卡瑞利珠单抗治疗驱动基因阴性晚期非小细胞肺癌临床观察[J]. 中国药业,2022,31(S02):72-74.
[17]	王素玲,常智. 卡瑞利珠单抗联合化疗对晚期非小细胞肺癌患者近期疗效、肺功能和血清肿瘤标志物的影响[J]. 现代医学与健康研究电子杂志,2022,6(24):42-45.
[18]	吴畅,胡小云,杨东晓,等. 卡瑞利珠单抗联合卡铂和培美曲塞治疗晚期非小细胞肺癌疗效分析[J]. 中文科技期刊数据库(全文版)医药卫生,2023,(6):98-100.
[19]	邢磊,叶惠兰,时海峰,等. 卡瑞利珠单抗联合化疗治疗晚期非小细胞肺癌的效果[J]. 吉林医学,2023,44(9):2528-2531. doi: 10.3969/j.issn.1004-0412.2023.09.044
[20]	徐菊娣,黄骞,杨志勇,等. 卡瑞利珠单抗辅助化疗对中晚期NSCLC患者的近期疗效及对细胞免疫、血清肿瘤标志物的影响[J]. 现代肿瘤医学,2023,31(6):1047-1051.
[21]	尤冬山,夏晓阳,陈爱民,等. 卡瑞利珠单抗联合TP方案对中晚期NSCLC患者疗效免疫功能及外周血VEGF bFGF CA125和CEA的影响[J]. 河北医学,2023,29(10):1743-1748. doi: 10.3969/j.issn.1006-6233.2023.10.031
[22]	张靖悦,郑光辉,聂改红. 卡瑞利珠单抗联合紫杉醇、卡铂化疗对晚期非小细胞肺癌的疗效[J]. 河南医学研究,2022,31(7):1310-1313. doi: 10.3969/j.issn.1004-437X.2022.07.042
[23]	朱宇宏. 卡瑞利珠单抗联合化疗对驱动基因阴性晚期非小细胞肺癌的效果分析[J]. 中文科技期刊数据库(文摘版)医药卫生,2023,(8):49-51.
[24]	Zou J,Li C,Han Y,et al. Efficacy of Camrelizumab in Advanced Non-Small-Cell Lung Cancer and Prognostic Analysis of Different PET/CT Features[J]. J Oncol,2022,2022:9942918.
[25]	Gao J,Zhang C,Wei Z,et al. Immunotherapy for early-stage non-small cell lung cancer: A system review[J]. J Cancer Res Ther,2023,19(4):849-865.
[26]	Cao H,Wei W,Lu Y. Camrelizumab plus chemotherapy in advanced non-squamous non-small cell lung cancer: Treatment response,survival pattern,and safety[J]. J Clin Pharm Ther,2022,47(11):1775-1782.
[27]	董惠霞,王茜. 非小细胞肺癌患者外周血T淋巴细胞亚群表达及其临床意义[J]. 医学信息,2023,36(18):136-139. doi: 10.3969/j.issn.1006-1959.2023.18.026
[28]	Trulson I,Holdenrieder S. Prognostic value of blood-based protein biomarkers in non-small cell lung cancer: A critical review and 2008-2022 update[J]. Tumour Biol,2024,46(s1):S111-S161. doi: 10.3233/TUB-230009
[29]	丁振兴,侯永乐,李百玮,等. 卡瑞利珠单抗联合化疗治疗晚期NSCLC的疗效及安全性Meta分析[J]. 齐齐哈尔医学院学报,2022,43(21):2058-2063. doi: 10.3969/j.issn.1002-1256.2022.21.013

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