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Cited by 11Cholangiocarcinoma and Gallbladder Cancer StudiesCancer Immunotherapy and BiomarkersPediatric Hepatobiliary Diseases and Treatments

Efficacy and Safety of Anti-PD1/PDL1 in Advanced Biliary Tract Cancer: A Systematic Review and Meta-Analysis

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Jiang, Qi, Huang, Jinsheng, Zhang, Bei, Li, Xujia, Chen, Xiuxing, Cui, Bokang, Li, Shengping, Guo, Guifang·2022·Frontiers in Immunology
DOI 10.3389/fimmu.2022.801909PMC PMC8924050
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Abstract

Background: Anti-programmed cell death protein 1 and its ligand (anti-PD1/PDL1) have been proposed as a promising therapeutic option for advanced biliary tract cancer (aBTC). Given the scarce quantitative analyses of anti-PD1/PDL1 in aBTC, we thus did a meta-analysis to assess the benefits and risks of this emerging treatment strategy in patients with aBTC. Methods: PubMed, Embase, the Cochrane Library, Web of Science, and meeting resources were searched for relevant studies. The main endpoints were median progression-free survival (mPFS), median overall survival (mOS), objective response rate (ORR), disease control rate (DCR), any-grade adverse events (AEs), and grade 3–4 AEs. Results: Twenty-eight studies with 1,338 participants were included. The best curative effect was found in the anti-PD1/PDL1 combined with anti-CTLA4 and chemotherapy group (mPFS: 12.4 months; mOS: 16.0 months; ORR: 45.1%; DCR: 95.0%), followed by the anti-PD1/PDL1 plus chemotherapy group (mPFS: 8.2 months; mOS: 14.8 months; ORR: 36.3%; DCR: 84.6%), the anti-PD1/PDL1 plus antiangiogenesis group (mPFS: 4.9 months; mOS: 10.2 months; ORR: 17.5%; DCR: 68.7%), the anti-PD1/PDL1 plus anti-cytotoxic T lymphocyte antigen 4 (anti-CTLA4) group (mPFS: 2.9 months; mOS: 8.3 months; ORR: 9.9%; DCR: 36.8%), and the anti-PD1/PDL1 monotherapy group (mPFS: 2.5 months; mOS: 7.6 months; ORR: 6.8%; DCR: 34.7%). Compared with anti-PD1-containing regimens, anti-PDL1-containing regimens achieved preferable mPFS (11.1 vs. 3.8 months), mOS (12.2 vs. 9.8 months), and ORR (23.7% vs. 17.4%), despite a similar DCR (61.1% vs. 61.3%). The mPFS, mOS, ORR, and DCR were 10.6 months, 15.8 months, 42.3%, and 88.6% of first-line anti-PD1/PDL1 and 3.0 months, 9.1 months, 11.6%, and 51.1% of second-line therapy or beyond, respectively. There were 80.6% and 34.0% of the patients suffering any-grade AEs and grade 3–4 AEs. Anti-PD1/PDL1 monotherapy might be considered as a safer alternative than combination regimens. Meanwhile, obvious toxicities in the first-line setting could not be neglected. Conclusions: Anti-PD1/PDL1 showed encouraging efficacy and acceptable safety profile in aBTC and, thus, could be an alternative treatment.

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Authors
Jiang, Q., Huang, J., Zhang, B., Li, X., Chen, X., Cui, B., Li, S., & Guo, G.
Affiliations
Sun Yat-sen University (CN)
Corresponding author
  • Li, Shengping
  • Guo, Guifang
ORCID
Venue
Frontiers in Immunology
Publisher
Frontiers Media SA
Published
2022-03-02
Volume
13
Pages
801909-801909
ISSN
1664-3224 (ISSN-L)
DOI
10.3389/fimmu.2022.801909
PMC
PMC8924050
OpenAlex
W4214823140
Cited by
11
References
65
Citations by year
2025: 3 · 2024: 3 · 2023: 5
FWCI
0.65
Type
journal article
Language
en
Open access
Licence
Locations
  • Frontiers in Immunology (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
Natural Science Foundation of Guangdong Province
Topics
  • Health Sciences › Medicine › Surgery › Cholangiocarcinoma and Gallbladder Cancer Studies
  • Health Sciences › Medicine › Oncology › Cancer Immunotherapy and Biomarkers
  • Health Sciences › Medicine › Surgery › Pediatric Hepatobiliary Diseases and Treatments
Keywords
advanced biliary tract cancer, immune checkpoint inhibitors, combination chemotherapy, anti-angiogenic therapy, progression-free survival, overall survival, objective response rate, adverse events, treatment safety, drug efficacy comparison, monotherapy versus combination therapy, chemoimmunotherapy
MeSH terms
Progression-Free Survival, Antineoplastic Combined Chemotherapy Protocols, Biliary Tract Neoplasms, Humans, Antibodies, Monoclonal, Humanized

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