细胞免疫疗法联合化疗对三阴性乳腺癌预后影响的Meta分析

Meta-Analysis of the Effect of Cellular Immunotherapy Combined with Chemotherapy on the Prognosis of Triple Negative Breast Cancer

摘要: 目的：目前，临床上关于CIK免疫治疗对TNBC患者影响的数据有限且有数个关于三阴性乳腺癌化疗联合细胞免疫治疗的回顾性研究。因此，我们进行了荟萃分析，旨在评估细胞免疫治疗联合化疗对三阴性乳腺癌患者有效性及安全性的影响。方法：用计算机在线检索PubMed、Embase、the Cochrane Library 三个数据库，严格按照纳入及排除标准，筛选出在2024年10月19前已发表的在三阴性乳腺癌化疗中对比了联合细胞免疫治疗与不联合细胞免疫治疗对三阴性乳腺癌患者影响的研究，采用纽卡斯尔–渥太华量表(Newcastle-Ottawa Scale, NOS)对最终纳入的文献进行质量评价，用Engauge Digitizer提取软件进行资料提取，之后用STATA 18.0软件进行相关的统计分析。结果：按照纳入标准严格筛选后，最终纳入五项回顾性病例对照研究，总共包含1248名患者。Meta分析结果表明与化疗相比，细胞免疫治疗联合化疗显著提高了TNBC患者的总生存期(OS)和无病生存期(DFS)。联合治疗与IIb期和III期较好的OS有显著相关性，而与I期和IIa期无显著相关性。联合治疗对于各个分期患者的DFS均无显著延长。接受 ≥ 6个周期细胞免疫治疗的患者有更高的OS和DFS。结论：本meta分析结果表明，三阴乳腺癌的细胞免疫治疗联合化疗可以改善患者的OS和DFS，晚期患者获益更为显著，并且 ≥ 6个周期细胞治疗效果甚佳。细胞免疫治疗联合化疗无3级以上不良反应发生且经对症治疗后得到缓解，表明联合治疗是安全的。

Abstract: Objective: Currently, clinical data on the impact of CIK immunotherapy on TNBC patients are limited, with several retrospective studies on triple-negative breast cancer chemotherapy combined with cellular immunotherapy. Therefore, this meta-analysis was conducted to evaluate the efficacy and safety of cellular immunotherapy combined with chemotherapy in patients with triple-negative breast cancer. Methods: Three databases, PubMed, Embase, and the Cochrane Library, were searched online by computer, and according to the inclusion and exclusion criteria, the authors were screened out of the triple-negative breast cancer chemotherapy published before October 19, 2024. Studies on the effects of plus cellular immunotherapy and no cellular immunotherapy on patients with triple-negative breast cancer were compared, and the Newcastle-Ottawa Scale (NOS) was used to evaluate the quality of the finally included studies. Data extraction was conducted with Engauge Digitizer, followed by statistical analysis with STATA 18.0. Results: After rigorous screening according to inclusion criteria, five retrospective case-control studies were eventually included, including a total of 1248 patients. The results of the meta-analysis showed that compared with chemotherapy, cellular immunotherapy combined with chemotherapy significantly improved the overall survival (OS) and disease-free survival (DFS) of TNBC patients. The combination therapy was significantly associated with better OS in stages IIb and III, but not with stages I and IIa. The combination therapy did not significantly prolong DFS in patients at any stage. Patients who received ≥ 6 cycles of cellular immunotherapy had higher OS and DFS. Conclusion: The results of this meta-analysis suggest that cell immunotherapy combined with chemotherapy can improve the OS and DFS of patients with triple-negative breast cancer, and the benefit is more significant in advanced patients, and the effect of ≥ 6 cycles of cell therapy is very good. Cell immunotherapy combined with chemotherapy did not have more than grade 3 adverse reactions and was alleviated after symptomatic treatment, indicating that the combination therapy was safe.