Immune Checkpoint Inhibitors and Survival Outcomes in Brain Metastasis: A Time Series-Based Meta-Analysis
Immune checkpoint inhibitors (ICIs) have shown potential to improve the prognosis of patients with brain metastasis (BM) caused by advanced cancers. However, controversies still exist in regard to its survival benefits. In the present work, a time series-based meta-analysis based on the phase I/II/I...
Main Authors: | , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Frontiers Media S.A.
2020-10-01
|
Series: | Frontiers in Oncology |
Subjects: | |
Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2020.564382/full |
id |
doaj-b42cd24cb94e4ccfaa6bdef5ad6eb252 |
---|---|
record_format |
Article |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Xingjiang Hu Xingjiang Hu Hui Yu Hui Yu Yunliang Zheng Yunliang Zheng Qiao Zhang Qiao Zhang Meihua Lin Meihua Lin Jialei Wang Jialei Wang Yunqing Qiu Yunqing Qiu |
spellingShingle |
Xingjiang Hu Xingjiang Hu Hui Yu Hui Yu Yunliang Zheng Yunliang Zheng Qiao Zhang Qiao Zhang Meihua Lin Meihua Lin Jialei Wang Jialei Wang Yunqing Qiu Yunqing Qiu Immune Checkpoint Inhibitors and Survival Outcomes in Brain Metastasis: A Time Series-Based Meta-Analysis Frontiers in Oncology immune checkpoint inhibitor brain metastasis survival prognosis meta-analysis |
author_facet |
Xingjiang Hu Xingjiang Hu Hui Yu Hui Yu Yunliang Zheng Yunliang Zheng Qiao Zhang Qiao Zhang Meihua Lin Meihua Lin Jialei Wang Jialei Wang Yunqing Qiu Yunqing Qiu |
author_sort |
Xingjiang Hu |
title |
Immune Checkpoint Inhibitors and Survival Outcomes in Brain Metastasis: A Time Series-Based Meta-Analysis |
title_short |
Immune Checkpoint Inhibitors and Survival Outcomes in Brain Metastasis: A Time Series-Based Meta-Analysis |
title_full |
Immune Checkpoint Inhibitors and Survival Outcomes in Brain Metastasis: A Time Series-Based Meta-Analysis |
title_fullStr |
Immune Checkpoint Inhibitors and Survival Outcomes in Brain Metastasis: A Time Series-Based Meta-Analysis |
title_full_unstemmed |
Immune Checkpoint Inhibitors and Survival Outcomes in Brain Metastasis: A Time Series-Based Meta-Analysis |
title_sort |
immune checkpoint inhibitors and survival outcomes in brain metastasis: a time series-based meta-analysis |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Oncology |
issn |
2234-943X |
publishDate |
2020-10-01 |
description |
Immune checkpoint inhibitors (ICIs) have shown potential to improve the prognosis of patients with brain metastasis (BM) caused by advanced cancers. However, controversies still exist in regard to its survival benefits. In the present work, a time series-based meta-analysis based on the phase I/II/III trials and observational studies were performed to investigate the differences in mortality of ICI-treated BM patients. A number of public library databases, including MEDLINE, EMBASE, OVID, and COCHRANE, were systemically searched by March 2019. The quality of included studies was evaluated by the Newcastle-Ottawa Scale (NOS) scoring. Outcome measures here established were mortality and progression-free survival (PFS) at different follow-up endpoints. Survival rates and curve data were pooled for further analysis. To detect the data heterogeneity, subgroup analyses were conducted according to tumor and ICI types. Eighteen studies, 6 trials, and 12 controlled cohorts were assessed, involving a total of 1330 ICI-treated BM patients. The 6-month survival rate and PFS were 0.67 (95%CI: 0.59–0.74) and 0.36 (95%CI: 0.24–0.49), respectively. According to the tumor type (melanoma, NSCLC, and RCC), subgroup analyses indicated that melanoma presented the lowest survival rates among the three groups here selected. In regard to the type of ICIs, the anti-CTLA-4 combined with the anti-PD-1/PD-L1 showed the best survival outcome among these groups. The 12-month survival rate and PFS showed a consistent pattern of findings. In the long-term, the 24-month survival rate and PFS were 0.20 (95%CI: 0.12–0.31) and 0.18 (0.05–0.46) in BM patients. Hence, ICI therapy may be associated with an improved prognosis of BM patients. Nevertheless, current research presented a limited study design. Multicenter randomized trials may later assist in validating ICI-based therapies for a better outcome of BM patients. |
topic |
immune checkpoint inhibitor brain metastasis survival prognosis meta-analysis |
url |
https://www.frontiersin.org/articles/10.3389/fonc.2020.564382/full |
work_keys_str_mv |
AT xingjianghu immunecheckpointinhibitorsandsurvivaloutcomesinbrainmetastasisatimeseriesbasedmetaanalysis AT xingjianghu immunecheckpointinhibitorsandsurvivaloutcomesinbrainmetastasisatimeseriesbasedmetaanalysis AT huiyu immunecheckpointinhibitorsandsurvivaloutcomesinbrainmetastasisatimeseriesbasedmetaanalysis AT huiyu immunecheckpointinhibitorsandsurvivaloutcomesinbrainmetastasisatimeseriesbasedmetaanalysis AT yunliangzheng immunecheckpointinhibitorsandsurvivaloutcomesinbrainmetastasisatimeseriesbasedmetaanalysis AT yunliangzheng immunecheckpointinhibitorsandsurvivaloutcomesinbrainmetastasisatimeseriesbasedmetaanalysis AT qiaozhang immunecheckpointinhibitorsandsurvivaloutcomesinbrainmetastasisatimeseriesbasedmetaanalysis AT qiaozhang immunecheckpointinhibitorsandsurvivaloutcomesinbrainmetastasisatimeseriesbasedmetaanalysis AT meihualin immunecheckpointinhibitorsandsurvivaloutcomesinbrainmetastasisatimeseriesbasedmetaanalysis AT meihualin immunecheckpointinhibitorsandsurvivaloutcomesinbrainmetastasisatimeseriesbasedmetaanalysis AT jialeiwang immunecheckpointinhibitorsandsurvivaloutcomesinbrainmetastasisatimeseriesbasedmetaanalysis AT jialeiwang immunecheckpointinhibitorsandsurvivaloutcomesinbrainmetastasisatimeseriesbasedmetaanalysis AT yunqingqiu immunecheckpointinhibitorsandsurvivaloutcomesinbrainmetastasisatimeseriesbasedmetaanalysis AT yunqingqiu immunecheckpointinhibitorsandsurvivaloutcomesinbrainmetastasisatimeseriesbasedmetaanalysis |
_version_ |
1724460686648541184 |
spelling |
doaj-b42cd24cb94e4ccfaa6bdef5ad6eb2522020-11-25T03:57:27ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2020-10-011010.3389/fonc.2020.564382564382Immune Checkpoint Inhibitors and Survival Outcomes in Brain Metastasis: A Time Series-Based Meta-AnalysisXingjiang Hu0Xingjiang Hu1Hui Yu2Hui Yu3Yunliang Zheng4Yunliang Zheng5Qiao Zhang6Qiao Zhang7Meihua Lin8Meihua Lin9Jialei Wang10Jialei Wang11Yunqing Qiu12Yunqing Qiu13Research Center of Clinical Pharmacy, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, ChinaZhejiang Provincial Key Laboratory for Drug Evaluation and Clinical Research, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, ChinaDepartment of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, ChinaDepartment of Oncology, Shanghai Medical College, Fudan University, Shanghai, ChinaResearch Center of Clinical Pharmacy, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, ChinaZhejiang Provincial Key Laboratory for Drug Evaluation and Clinical Research, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, ChinaResearch Center of Clinical Pharmacy, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, ChinaZhejiang Provincial Key Laboratory for Drug Evaluation and Clinical Research, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, ChinaResearch Center of Clinical Pharmacy, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, ChinaZhejiang Provincial Key Laboratory for Drug Evaluation and Clinical Research, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, ChinaDepartment of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, ChinaDepartment of Oncology, Shanghai Medical College, Fudan University, Shanghai, ChinaResearch Center of Clinical Pharmacy, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, ChinaZhejiang Provincial Key Laboratory for Drug Evaluation and Clinical Research, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, ChinaImmune checkpoint inhibitors (ICIs) have shown potential to improve the prognosis of patients with brain metastasis (BM) caused by advanced cancers. However, controversies still exist in regard to its survival benefits. In the present work, a time series-based meta-analysis based on the phase I/II/III trials and observational studies were performed to investigate the differences in mortality of ICI-treated BM patients. A number of public library databases, including MEDLINE, EMBASE, OVID, and COCHRANE, were systemically searched by March 2019. The quality of included studies was evaluated by the Newcastle-Ottawa Scale (NOS) scoring. Outcome measures here established were mortality and progression-free survival (PFS) at different follow-up endpoints. Survival rates and curve data were pooled for further analysis. To detect the data heterogeneity, subgroup analyses were conducted according to tumor and ICI types. Eighteen studies, 6 trials, and 12 controlled cohorts were assessed, involving a total of 1330 ICI-treated BM patients. The 6-month survival rate and PFS were 0.67 (95%CI: 0.59–0.74) and 0.36 (95%CI: 0.24–0.49), respectively. According to the tumor type (melanoma, NSCLC, and RCC), subgroup analyses indicated that melanoma presented the lowest survival rates among the three groups here selected. In regard to the type of ICIs, the anti-CTLA-4 combined with the anti-PD-1/PD-L1 showed the best survival outcome among these groups. The 12-month survival rate and PFS showed a consistent pattern of findings. In the long-term, the 24-month survival rate and PFS were 0.20 (95%CI: 0.12–0.31) and 0.18 (0.05–0.46) in BM patients. Hence, ICI therapy may be associated with an improved prognosis of BM patients. Nevertheless, current research presented a limited study design. Multicenter randomized trials may later assist in validating ICI-based therapies for a better outcome of BM patients.https://www.frontiersin.org/articles/10.3389/fonc.2020.564382/fullimmune checkpoint inhibitorbrain metastasissurvivalprognosismeta-analysis |