肌减少症对实体瘤患者免疫检查点抑制剂治疗影响的meta分析

目的 探究肌减少症对免疫检查点抑制剂(immune checkpoint Inhibitor,ICIs)的短期疗效、远期预后和免疫相关不良反应的影响。方法 对PubMed、EMBASE和Cochrane数据库中在2021年6月前发表的关于肌减少症对免疫治疗的实体瘤患者短期疗效、远期预后和免疫相关不良反应影响的文献进行检索。采用Review Manager 5.3软件和Stata14.0软件进行统计分析。结果 共有27篇文献被纳入荟萃分析，Meta分析结果显示合并肌减少症可降低肿瘤患者免疫治疗的客观反应率(RR=0.11,95%CI:0.02～0.54)和疾病控制率(RR=0.55,95%CI:0.39～0.78)。同时，治疗前合并肌减少症是肿瘤患者预后不良的危险因素(OS:HR=1.60,95%CI:1.30～1.97;PFS:HR=2.81,95%CI:1.88～4.22),甚至在治疗期间肌减少也是患者预后不良的危险因素。合并肌减少症会增加患者发生严重免疫相关不良事件的风险(RR=1.27;95%CI:0.74～2.19)。结论 肌减少症是肿瘤患者免疫治疗效果和预后不佳的危险因素。

Sarcopenia on immune checkpoint inhibitors in solid tumor patients with sarcopenia: A meta-analysis

Objective To explore the effect of sarcopenia on the short-term efficacy, long-term prognosis and immune-related adverse events (irAEs) of immune checkpoint Inhibitor (ICIs). Methods A systematic search were conducted in the PubMed, EMBASE, and Cochrane databases to include relevant studies published before June 2021. Results A total of 27 studies were included in the Meta-analysis, which showed that the patients with sarcopenia had worse the objective response rate (RR=0.11, 95%CI: 0.02-0.54) and disease control rate (RR=0.55, 95%CI:0.39-0.78) than those without the disease. In addition, pooled sarcopenia was found to be a unfavorable prognostic factor of prognosis in tumor patients (OS: HR=1.60, 95%CI: 1.30-1.97; PFS: HR=2.81, 95%CI: 1.88-4.22). Furthermore, sarcopenia tended toward irAEs (RR=1.27;95%CI:0.74-2.19). Conclusion Sarcopenia may be considered as a risk factor for poor therapeutic effect and prognosis in cancer patients.