Combination of immunotherapy and chemotherapy as first-line treatment for advanced or recurrent endometrial cancer: a meta-analysis of phase 3 trials
Abstract
BACKGROUND: The integration of immunotherapy with chemotherapy (CT) has emerged as a major focus of clinical research in recent years for patients with advanced or recurrent endometrial cancer (EC). Recent phase 3 randomized controlled trials (RCTs) have reported heterogeneous outcomes, prompting ongoing debate within the oncology community. This study aimed to evaluate the efficacy and safety of this combined approach through a meta-analysis of phase 3 RCTs. METHODS: A systematic literature search identified phase 3 RCTs comparing first-line immunotherapy plus CT versus CT alone in advanced or recurrent EC. Meta-analyses were performed to pool hazard ratios (HRs) for progression-free survival (PFS) and overall survival (OS), odds ratios (ORs) for objective response rate (ORR), and relative risks (RRs) for adverse events (AEs). RESULTS: Four phase 3 RCTs (n = 2,334) met eligibility criteria. The combination therapy significantly improved PFS (HR, 0.60; 95% CI, 0.47–0.78), OS (HR, 0.75; 95% CI, 0.65–0.87), and ORR (OR, 1.42; 95% CI, 1.17–1.73) compared to CT alone. While a modest increase in grade 3–5 AEs (RR, 1.11; 95% CI, 1.03–1.20) was observed with combination therapy, there was no significant rise in serious AEs. Subgroup analyses revealed enhanced survival benefits in patients with mismatch repair-deficient (dMMR) tumors, PD-L1-positive tumors, and recurrent disease. CONCLUSION: This meta-analysis demonstrates that combining immunotherapy with CT as first-line treatment…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 2,334 participants or records.
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