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肿瘤突变负荷预测免疫检查点抑制剂对胃肠道恶性肿瘤患者疗效的Meta分析
赖祥丽1，陈志新2，沈永奇1，覃君云1，林德帅1，刘金娥1，莫　雀1，韩朝稳1
1.柳州市柳铁中心医院肿瘤科，广西 545007；2.广西医科大学第四附属医院（柳州市工人医院）消化内科，柳州 545005
摘要:
［摘要］　目的　系统评价肿瘤突变负荷(TMB)预测免疫检查点抑制剂(ICIs)对胃肠道恶性肿瘤患者疗效的价值。方法　检索PubMed、Web of Science、Cochrane Library三个数据库从建库至2021年12月1日的相关文献963篇，最终纳入12篇文献（包含1 126例接受ICIs治疗的胃肠道恶性肿瘤患者）进行Meta分析。主要评价指标包括客观缓解率(ORR)、无进展生存期(PFS)和总生存期(OS)。结果　在接受ICIs治疗的患者中，与低TMB者相比，高TMB者有更长的OS［HR(95%CI)=0.71(0.51～0.97)，P=0.031］，更高的ORR［OR(95%CI)=4.22(2.58～6.90)，P<0.001］，但两者PFS无显著差异［HR(95%CI)=0.77(0.48～1.23)，P=0.276］。结论　高TMB胃肠道恶性肿瘤患者更有机会从ICIs治疗中获益。
关键词:  肿瘤突变负荷  胃肠道恶性肿瘤  免疫检查点抑制剂  Meta分析
DOI：10.3969/j.issn.1674-3806.2024.08.14
分类号:R 735
基金项目:广西自然科学基金项目（编号：2018GXNSFAA281034）；柳州市科技计划重点研发项目（编号：2018BJ10506）；广西壮族自治区卫生健康委员会自筹经费科研课题（编号：Z20200564，Z-B20221528）
Meta-analysis of tumor mutation burden predicting the efficacy of immune checkpoint inhibitors in patients with gastrointestinal malignancies
LAI Xiangli1, CHEN Zhixin2, SHEN Yongqi1, QIN Junyun1, LIN Deshuai1, LIU Jin′e1, MO Que1, HAN Chaowen1
1.Department of Oncology, Liuzhou Municipal Liutie Central Hospital, Guangxi 545007, China; 2.Department of Gastroenterology, the Fourth Affiliated Hospital of Guangxi Medical University(Liuzhou Worker′s Hospital), Liuzhou 545005, China
Abstract:
［Abstract］　Objective　To systematically evaluate the value of tumor mutation burden(TMB) predicting the efficacy of immune checkpoint inhibitors(ICIs) in patients with gastrointestinal malignancies. Methods　A total of 963 papers of the relevant literature in PubMed, Web of Science and Cochrane Library databases from the time of establishment to December 1 2021 were searched, and 12 papers of the relevant literature(including 1 126 cases of gastrointestinal malignancies treated with ICIs) were finally included for Meta-analysis. The main evaluation indicators included objective response rate(ORR), progression-free survival(PFS), and overall survival(OS). Results　In the patients treated with ICIs, the patients with high TMB had longer OS［HR(95%CI)=0.71(0.51-0.97), P=0.031］, and higher ORR［OR(95%CI)=4.22(2.58-6.90), P<0.001］ compared with those with low TMB. However, there was no significant difference in PFS between the two group of the patients［HR(95%CI)=0.77(0.48-1.23), P=0.276］. Conclusion　The gastrointestinal malignancy patients with high TMB are more likely to benefit from the treatment of ICIs.
Key words:  Tumor mutation burden(TMB)  Gastrointestinal malignancy  Immune checkpoint inhibitors(ICIs)  Meta-analysis