Cancer immunotherapy represents a more advanced and effective treatment modality compared to traditional therapies, playing a significant role in the management of patients with nasopharyngeal carcinoma. However, the efficacy of immunotherapy can be influenced by the 'double-edged sword' nature of the immune system and the individual differences among cancer patients. To assess the efficacy and safety of immunotherapy in patients with nasopharyngeal carcinoma, we conducted a systematic review and meta-analysis of published clinical studies. Clinical research literature related to nasopharyngeal carcinoma immunotherapy was searched in the PubMed, Web of Science, Embase, and Cochrane databases up until December 2010. The literature was screened rigorously according to predefined inclusion and exclusion criteria. Quality evaluation of the included studies was conducted using the Newcastle-Ottawa Scale (NOS), and studies meeting the inclusion criteria were extracted for analysis and evaluation. The Chi-square test and I2 statistic were utilized to assess heterogeneity, while publication bias was examined through the construction of a funnel plot and the application of the Egger test. A total of 19 studies were included in this meta-analysis, including 2,354 patients with nasopharyngeal carcinoma. The results showed that immunotherapy had a good therapeutic effects on patients with nasopharyngeal carcinoma. The 0.5-3 year PFS of patients with nasopharyngeal carcinoma who received immunotherapy was significantly improved compared to the group who did not receive immunotherapy (OR: 1.87; 95% CI 1.22-2.85) and 0.5-3 year OS were also significantly improved (OR: 1.45; 95% CI 1.23-1.74). In terms of treatment-related adverse events (AEs), the incidence of ≥ grade 3 treatment-related AEs was 27% (95% CI 25-30%), and the incidence of combination therapy was higher than that of monotherapy. In the treatment of patients with nasopharyngeal carcinoma, immunotherapy has demonstrated superior efficacy compared to chemotherapy alone. Furthermore, the expression levels of EBV DNA and PD-L1 in the serum of patients significantly influence the therapeutic outcomes.
Key words: Nasopharyngeal carcinoma, immunotherapy, curative effect, safety, programmed cell death-ligand 1, epstein-barr virus
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