Journal Article Systematic Review Comparative Study Network Meta-Analysis Epublish
PubMed: 40022109 DOI: 10.1186/s12905-025-03612-7
Efficacy comparison of PD-1/PD-L1 inhibitor monotherapy and combination with PARPis or antiangiogenic agents in advanced or recurrent endometrial cancer: a systematic review and network meta-analysis.
BMC Womens Health 25(1):93
Authors: Shiya Ji, Xupeng Chen, Yebo Yu, Qiuping Jia, Xingxing Zhang, Zixin Gao
Affiliations
- Department of Health Education, Nanjing Municipal Center for Disease Control and Prevention, No.16 Kunlun Road, Nanjing, 210003, Jiangsu Province, China.
- Department of Health Education, Nanjing Municipal Center for Disease Control and Prevention, No.16 Kunlun Road, Nanjing, 210003, Jiangsu Province, China.
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, China.
- Department of Health Education, Jiangning District Center for Disease Control and Prevention, Nanjing, China.
- High School Affiliated to Nanjing Normal University, Nanjing, China.
Abstract
PURPOSE
The network meta-analysis (NMA) was aimed to compare and assess the effectiveness of programmed cell death 1 (PD-1)/ programmed cell death ligand 1 (PD-L1) inhibitor monotherapy or combination therapy with other agents for individuals with advanced or recurrent endometrial cancer (EC).
METHODS
The NMA was registered on the PROSPERO website (ID: CRD42024545968) and multiple databases were queried to retrieve the articles. It assessed the progression-free survival (PFS) and overall survival (OS) of persons with advanced or recurrent EC, as well as those with deficient mismatch repair (dMMR) and proficient mismatch repair (pMMR) in terms of PFS.
RESULTS
The NMA included 12 studies involving a total of 4,515 patients. Compared to chemotherapy, the PD-1/PD-L1 inhibitor monotherapy (hazard ratio [HR], 0.59; 95% confidence interval [CI]: 0.44-0.78) in PFS, combination therapy with poly (ADP-ribose) polymerase inhibitors (PARPis) (HR, 0.53; 95% CI: 0.32-0.89) or with antiangiogenic agents (HR, 0.48; 95% CI: 0.25-0.83) all showed significant improvements in PFS. PD-1/PD-L1 inhibitor monotherapy resulted in a significantly higher OS (HR, 0.61; 95% CI: 0.37-0.97) compared to chemotherapy. Combination therapy with antiangiogenic agents demonstrated the highest efficacy in extending PFS, while the combination with PARPis had the best performance in extending OS. Patients with dMMR and pMMR subtypes derive greater benefits from PD-1/ PD-L1 inhibitor monotherapy and PD-1/PD-L1 inhibitors combined with PARPis respectively.
CONCLUSION
Monotherapy with PD-1/PD-L1 inhibitors and combination therapies with PARPis or antiangiogenic agents demonstrate significant potential for individuals with advanced or recurrent EC.
MeSH
Cells, Dna Mismatch Repair, Poly(Adp-Ribose) Polymerases, Angiogenesis Inhibitors, Neoplasms, Poly Adenosine Diphosphate Ribose, Drug Therapy, Network Meta-Analysis, Therapeutics, Cell Death, Endometrial Neoplasms, Chemotherapy