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| 1 | 帕博利珠单抗联合以铂类为基础的化疗治疗非小细胞肺癌合并稳定性脑转移患者的结局:KEYNOTE-021、-189和-407研究的汇总分析显示文摘背景与目的此项探索性分析回顾评价了晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)患者的结局,旨在确定基线时合并脑转移是否会影响一线应用帕博利珠单抗联合化疗(pembrolizumab plus chemotherapy,PC)比对单用化疗的疗效。患者和方法对KEYNOTE-021队列G(非鳞癌)、KEYNOTE-189(非鳞癌)和KEYNOTE-407(鳞癌)三项研究晚期NSCLC患者的数据进行汇总分析。患者接受含铂两药化疗和/或35个周期帕博利珠单抗治疗(每3周200 mg)。所有研究均纳入了经治或初治的稳定性脑转移患者(KEYNOTE-189与KEYNOTE-407研究纳入初治脑转移患者)。经治的脑转移患者已处于病情稳定的状态≥2周(KEYNOTE-021队列G患者≥4周),无新发或脑转移病灶扩大的证据且入组前至少3天以上未使用激素。初治的无症状脑转移患者需定期接受脑部影像学检查。结果共纳入1298例患者,其中171例有基线脑转移,1127例无脑转移。两组的中位随访时间(范围)在数据截止时分别为10.9(0.1-35.1)个月和11.0(0.1-34.9)个月。合并脑转移和无脑转移患者的总生存期[0.48(95%CI:0.32-0.70)和0.63(95%CI:0.53-0.75)]和无进展生存期[0.44(95%CI:0.31-0.62)和0.55(95%CI:0.48-0.63)]的风险比(PC/化疗)相似。合并脑转移的患者中,PC组和单用化疗组患者的中位总生存期分别为18.8个月和7.6个月,中位无进展生存期分别为6.9个月和4.1个月。无论是否合并脑转移,PC组患者的客观缓解率都高于单用化疗组,且缓解持续时间有显著延长。合并脑转移的患者中,PC组与单用化疗组的治疗相关不良事件发生率分别为88.2%和82.8%;而无脑转移的患者中,两组治疗相关不良事件的发生率分别为94.5%和90.6%。结论无论是否合并脑转移,与单用化疗相比,帕博利珠单抗联合以铂类为基础的组织学特异性化疗可改善所有PD-L1亚组的临床结局,其中包括PD-L1肿瘤比例评分<1%的患者,并且在晚期NSCLC患者中安全性良好。该方案是晚期NSCLC初治患者的标准方案,并可用于合并稳定性脑转移的患者。 | 周清(翻译校对) Steven F Powell Delvys Rodríguez-Abreu Corey J Langer Ali Tafreshi Luis Paz-Ares Hans-Georg Kopp Jeronimo Rodríguez-Cid Dariusz M Kowalski Ying Cheng Takayasu Kurata Mark M Awad Jinaxin Lin Bin Zhao M Catherine Pietanza Bilal Piperdi Marina C Garassino | 2022 | 中国肺癌杂志2022，25，1： | 6 |
| 2 | Endoscopic ultrasound-guided vs endoscopic retrograde cholangiopancreatography biliary drainage for obstructed distal malignant biliary strictures: A systematic review and meta-analysis显示文摘BACKGROUND For palliation of malignant biliary obstruction(MBO), the gold-standard method of biliary drainage is endoscopic retrograde cholangiopancreatography(ERCP)with the placement of metallic stents. Endoscopic ultrasound(EUS)-guided drainage is an alternative that is typically reserved for cases of ERCP failure.Recently, however, there have been robust randomized clinical trials(RCTs)comparing EUS-guided drainage and ERCP as primary approaches to MBO.AIM To compare EUS guidance and ERCP in terms of their effectiveness and safety in palliative biliary drainage for MBO.METHODS This was a systematic review and meta-analysis, in which we searched the MEDLINE, Excerpta Medica, and Cochrane Central Register of Controlled Trials databases. Only RCTs comparing EUS and ERCP for primary drainage of MBO were eligible. All of the studies selected provided data regarding the rates of technical and clinical success, as well as the duration of the procedure, adverse events, and stent patency. We assessed the risk of biases using the Jadad score and the quality of evidence using the Grading of Recommendations Assessment,Development and Evaluation criteria.RESULTS The database searches yielded 5920 records, from which we selected 3 RCTs involving a total of 222 patients(112 submitted to EUS and 110 submitted to ERCP). In the EUS and ERCP groups, the rate of technical success was 91.96%n and 91.81%, respectively, with a risk difference(RD) of 0.00%(95%CI:-0.07, 0.07;P = 0.97; I^2 = 0%). The clinical success was 84.81% and 85.53% in the EUS and ERCP groups, respectively, with an RD of-0.01%(95%CI:-0.12, 0.10; P = 0.90; I^2 =0%). The mean difference(MD) for the duration of the procedure was-0.12%(95%CI:-8.20, 7.97; P = 0.98; I^2 = 84%). In the EUS and ERCP groups, there were14 and 25 adverse events, respectively, with an RD of-0.06%(95%CI:-0.23, 0.12; P= 0.54; I^2 = 77%). The MD for stent patency was 9.32%(95%CI:-4.53, 23.18; P =0.19; I^2 = 44%). The stent dysfunction rate was significantly lower in the EUS t group(MD =-0.22%; 95 CI:-0.35,-0.08; P = 0.001; I^2 = 0%).CONCLUSION EUS represents an interesting alternative to ERCP for MBO drainage,demonstrating lower stent dysfunction rates compared with ERCP. Technical and clinical success, duration, adverse events and patency rates were similar. | Fernanda P Logiudice Wanderlei M Bernardo Facundo Galetti Vitor M Sagae Carolina O Matsubayashi Antonio C Madruga Neto Vitor O Brunaldi Diogo T H de Moura Tomazo Franzini Spencer Cheng Sergio E Matuguma Eduardo G H de Moura | 2019 | World Journal of Gastrointestinal Endoscopy2019，11，4： | 6 |
| 3 | Genetic transformation of wheat mediated by Agrobacterium tumefaciens显示文摘 | Cheng M Fry J E Pang S Zhou H Hironaka C M Duncan D R Conner T W Wan Y | 1997 | Plant Physiol1997，，： | 2 |
| 4 | Effect of saikosaponin, a triterpene saponin, on apoptosis in lymphocytes: association with c-myc, p53, and bc1-2 mRNA 显示文摘 | Hsu M J Cheng J S Huang H C | 2000 | Br J Pharmacol2000，131，7： | 2 |
| 5 | Effects of the phase-separated melt on crystallization behavior and morphology in short chain branched metallocene polyethylenes显示文摘 | Fu Q Chiu F C McCreight K W Guo M Tseng W W Cheng S Z Keating M Y Hsieh E T and DesLauriers P J | | 0，，： | 2 |
| 6 | A concise survey of scheduling with time-dependent processing times显示文摘 | Cheng T C E Ding Q Lin B M T | 2004 | European Journal of Operational Research2004，152，： | 1 |
| 7 | Damage-based formability analysis for TWBs显示文摘 | Cheng C H Jie M | 2005 | International Journal of Damage Mechanics2005，14，1： | 1 |
| 8 | Pressure and force fluctuations on isolated roughened circular cylinders of finite height in boundary layer flows 显示文摘 | KAREEM A CHENG C M | 1999 | Journal of Fluids and Structures1999，13，78： | 1 |
| 9 | Inequalities for eigenvalues of a clamped plate problem显示文摘 | Cheng Q M Yang H C | 2006 | Trans Amer Math Soc2006，358，6： | 1 |
| 10 | Determining the Minimum Crack Width That Can Be Detected Using the Impact-Echo Method-Part I:Experimental Study显示文摘 | Cheng C Sansalone M | 1995 | Material and Structures1995，28，： | 1 |
| 11 | Direct observation of short-circuit diffusion during the formation of a single cupric oxide nanowire显示文摘 | Cheng C L Ma Y R Chou M H | 2007 | Nanotechnology2007，18，24： | 1 |
| 12 | Characteristics, apa tire-forming ability and corrosion resistance of NiTi surface modified by AC anodization 显示文摘 | WONG M H CHENG F T MAN H C | 2007 | Appl Surface Sci2007，253，18： | 1 |
| 13 | Emergence of excitotoxicity in cultured forebrain neurons coincides with larger glutamate-stimulated i increases and NMDA receptor mRNA levels显示文摘 | CHENG C FASS D M REYNOLDS I J | 1999 | Brain Res1999，849，12： | 1 |
| 14 | Design and analysis of a new doubly salient permanent magnet motor显示文摘 | Cheng M Chau K T Chan C C | 2001 | IEEE Trans on Magnetics2001，37，4： | 1 |
| 15 | Degradation of azo dye procion red by photocatalytic oxidation 显示文摘 | So C Cheng M Yu J | 2002 | Chemosphere2002，46，6： | 1 |
| 16 | Electron microscopic studies of the morphogenesis of duck enteritis virus显示文摘 | Yuan G P Cheng A C Wang M S | 2005 | Avian Dis2005，49，1： | 1 |
| 17 | Comparison of strain-rate dependent stress-strain behavior from K0-consolidated compression and Extension tests on natural Hong Kong marine deposits显示文摘 | YIN J H CHENG C M | 2006 | Marine Georesouces and Geotechnology2006，24，： | 1 |
| 18 | Cryptanalysis of a remote user authentication scheme using smart cards显示文摘 | CHAN C K CHENG L M | 2000 | IEEE Transactions on Consumer Electronics2000，46，4： | 1 |
| 19 | Phosphate removal from water using lithium intercalated gibbsite 显示文摘 | Wang S L Cheng C Y Tzou Y M | 2007 | J Hazard Mater2007，147，： | 1 |
| 20 | Numerical simulation for isothermal dendritic growth of succinonitrile-acetone alloy显示文摘 | CHEN Z CHENG C L HAO L M | 2008 | Transactions of Nonferrous Metals Society of China2008，18，： | 1 |
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