帕博利珠单抗联合仑伐替尼治疗晚期肾细胞癌和晚期子宫内膜癌的疗效和安全性的 meta 分析

OBJECTIVE To evaluate the efficacy and safety of pembrolizumab combined with lenvatinib in the treatment of advanced renal cell carcinoma and advanced endometrial carcinoma. METHODS Searched Pubmed, EMBase, Cochrane Library, ISI Web of Science, CNKI, Wanfang database and VIP database by computer. According to the inclusion criteria and exclusion criteria, the relevant clinical randomized controlled trials of pembrolizumab combined with lenvatinib in the treatment of advanced renal cell carcinoma and advanced endometrial carcinoma were collected, and meta-analysis was performed using RevMan5.3 software. RESULTS A total of 4 493 patients were included in 6 studies, including 1 883 patients in the experimental group and 2 610 patients in the control group. The results of meta-analysis showed: pembrolizumab combined with lenvatinib showed progression-free survival[HR=0.51, 95%CI(0.40, 0.64), P<0.000 01], overall survival[HR=0.63, 95%CI(0.54, 0.74), P<0.000 01], objective response rate[RR=1.99, 95%CI(1.80, 2.21), P<0.000 01] and complete response rate[RR=3.11, 95%CI(1.41, 6.87), P=0.005] were significantly better than the control group, and the difference was statistically significant. In terms of safety, meta-analysis showed no statistically significant difference in grade 3 or more adverse events that occurred or worsened in the treatment of advanced renal cell carcinoma and advanced endometrial carcinoma[RR=1.08, 95%CI(0.97, 1.19), P=0.14] in combination with pembrolizumab. CONCLUSION Pembrolizumab combined with lenvatinib has good efficacy in the treatment of advanced renal cell carcinoma and advanced endometrial carcinoma, and provides a new regimen for the treatment of advanced solid tumors.