【佳學(xué)基因靶向藥物基因檢測】非 EGFR 突變/ALK 基因重排 NSCLC 腦轉(zhuǎn)移的基于放療的聯(lián)合治療：網(wǎng)絡(luò)薈萃分析

基因腫瘤檢測的英文——答案

綜述癌癥的檢測基因解碼創(chuàng)新治療在《腫瘤診斷基因與轉(zhuǎn)移分析》收錄《Front Oncol》在?2022 Nov 28;12:1024833.發(fā)表了一篇題目為《》腫瘤靶向藥物治療基因檢測臨床研究文章。該研究由Min Wu,?Jun Jiang,?Xuewen Zhang,?Jie Chen,?Qiaomei Chang,?Rong Chen等完成。促進(jìn)了腫瘤的正確治療與個性化用藥的發(fā)展，進(jìn)一步強(qiáng)調(diào)了基因信息檢測與分析的重要性。

腫瘤基因檢測及靶向藥物治療研究關(guān)鍵詞：

非小細(xì)胞肺癌,貝葉斯網(wǎng)絡(luò)薈萃分析,腦轉(zhuǎn)移,神經(jīng)腫瘤學(xué),放療。

腫瘤治療檢測基因臨床應(yīng)用結(jié)果

簡介：放療 (RT) 是目前治療非小細(xì)胞肺癌 (NSCLC) 腦轉(zhuǎn)移 (BM) 的主要方法。由于放療生存時間短，不良反應(yīng)明顯，我們迫切需要更合適的治療方法。本網(wǎng)絡(luò)薈萃分析回顧了以放療為基礎(chǔ)的聯(lián)合治療對無靶向表皮生長因子受體（EGFR）突變/間變性淋巴瘤激酶（ALK）基因重排的NSCLC BM患者的療效和不良反應(yīng)，以篩選出療效賊佳的療法. 佳學(xué)基因解碼的途徑：檢索 PubMed、Embase、Web of Science 和 Cochrane Library，檢索時間為可獲得的賊早出版日期至 2022 年 4 月 1 日。使用 STATA15.0 進(jìn)行異質(zhì)性分析、敏感性分析、森林圖分析和發(fā)表偏倚分析。結(jié)果: 共有 28 項(xiàng)研究，涉及 3707 名患者被納入貝葉斯網(wǎng)絡(luò)薈萃分析。在針對頭對頭比較試驗(yàn)的有限配對薈萃分析中，與基于放療的聯(lián)合療法相比，放療聯(lián)合免疫檢查點(diǎn)抑制劑 (ICI) 顯示出顯著的總生存 (OS) 獲益（HR 0.65，95%CI 0.47- 0.9，p<0.01），RT 聯(lián)合 ICIs 顯示顱內(nèi)無進(jìn)展生存期（iPFS）（HR 0.76，95%CI 0.27-2.27，p<0.01）和無進(jìn)展生存期（PFS）無顯著差異（ HR 0.9，95%CI 0.36-2.37，p<0.01）。此外，根據(jù)排序結(jié)果，與放療聯(lián)合化療（CT）或靶向治療（TT）相比，放療聯(lián)合ICIs可能是OS的賊佳治療模式（ICIs+RT vs CT+RT vs TT+RT ；91.9% vs. 27.8% vs. 29.3%，iPFS（ICIs+RT vs CT+RT vs TT+RT，46.9% vs. 25.2% vs. 25.6%）和 PFS（ICIs+RT vs CT+RT vs TT+RT， 36.2% vs 31% vs 36.5%)。藥物指導(dǎo)及病因判斷的依據(jù)：RT聯(lián)合ICIs可能是延長非EGFR突變/ALK基因重排NSCLC BMs OS的賊佳治療模式。評論注冊：https://www.crd .york.ac.uk/prospero/display_record.php?ID=CRD42022350065，標(biāo)識符 (CRD42022350065)。關(guān)鍵詞：NSCLC；貝葉斯網(wǎng)絡(luò)薈萃分析；腦轉(zhuǎn)移；神經(jīng)腫瘤學(xué)；放療。

腫瘤發(fā)生與革命國際數(shù)據(jù)庫描述：

Introduction:?Radiotherapy (RT) is currently the main treatment for brain metastases (BMs) from non-small cell lung cancer (NSCLC). Due to the short survival time and obvious adverse reactions of RT, we urgently need more appropriate treatment. This network meta-analysis reviewed the efficacy and adverse effects of radiotherapy-based combination therapy for patients without targeted epidermal growth factor receptor (EGFR) mutations/anaplastic lymphoma kinase (ALK) gene rearrangement NSCLC BMs, to screen out the therapy with the best efficacy.Methods:?PubMed, Embase, Web of Science, and Cochrane Library were searched from the earliest publication date available to 1 April 2022. STATA15.0 was used to conduct heterogeneity analysis, sensitivity analysis, forest plot analysis, and publication bias analysis.Results:?A total of 28 studies, involving 3707 patients were included in the Bayesian network meta-analysis. In the limited paired meta-analysis for head-to-head comparative trials, compared with RT-based combination therapy, RT combined with Immune checkpoint inhibitors (ICIs) showed significant overall survival (OS) benefit (HR 0.65, 95%CI 0.47-0.9, p<0.01), RT combined with ICIs showed a non-significant difference for intracranial progression-free survival (iPFS) (HR 0.76, 95%CI 0.27-2.27, p<0.01) and progression-free survival (PFS) (HR 0.9, 95%CI 0.36-2.37, p<0.01). In addition, according to the ranking results, compared with RT combined with chemotherapy(CT) or with targeted therapy(TT), RT combined with ICIs might be the best treatment mode for OS(ICIs+RT vs CT+RT vs TT+RT; 91.9% vs. 27.8% vs. 29.3%, iPFS (ICIs+RT vs CT+RT vs TT+RT, 46.9% vs 25.2% vs 25.6%) and PFS (ICIs+RT vs CT+RT vs TT+RT, 36.2% vs 31% vs 36.5%).Conclusions:?RT combined with ICIs might be the best treatment mode to prolong the OS for BMs from NSCLC with non-EGFR mutation/ALK gene rearrangement.Review registration:?https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022350065, identifier (CRD42022350065).Keywords:?NSCLC; bayesian network meta-analysis; brain metastasis; neuro-oncology; radiotherapy.