AUTHOR=Zhou Jianpeng , Li Jia , Fan Zhongqi , Lv Guoyue , Wang Guangyi 

TITLE=Clinical outcomes of immune checkpoint inhibitor combined with other targeted or immunological therapy regimens for the treatment of advanced bile tract cancer: a systematic review and meta-analysis

JOURNAL=Frontiers in Immunology

VOLUME=15

YEAR=2024

URL=https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2024.1378760

DOI=10.3389/fimmu.2024.1378760

ISSN=1664-3224

ABSTRACT=<sec><title>Background and aims</title><p>A single immune checkpoint inhibitor (ICI) regimen has limited value in treating advanced bile tract cancer (BTC); therefore, ICI combination therapy is often applied. This meta-analysis aimed to evaluate the effectiveness and safety of ICI combination therapy for advanced BTC.</p></sec><sec><title>Methods</title><p>The study protocol was registered on PROSPERO (CRD42023452422). Data on the median progression-free survival (PFS), median overall survival (OS), objective response rate (ORR), disease control rate (DCR), and grade ≥3 adverse events (AEs) reported in relevant studies were pooled and analyzed to determine the efficacy and safety of ICI combination therapy.</p></sec><sec><title>Results</title><p>In total, 15 studies with 665 patients were included in this meta-analysis. The overall ORR and DCR were 34.6% and 77.6%, respectively. The overall median PFS and OS were 6.06 months [95% confidence interval (CI): 4.91–7.21] and 12.11 months (95% CI: 10.66–13.55), respectively. Patients receiving ICI combination therapy in addition to other therapies had a considerably prolonged median PFS and OS (z=9.69, <italic>p</italic>&lt;0.001 and z=16.17, <italic>p</italic>&lt;0.001). Patients treated as first-line treatment had a substantially longer median PFS and OS compared to patients treated as non-first-line treatment (z=11.19, <italic>p</italic>&lt;0.001 and z=49.17, <italic>p</italic>&lt;0.001). The overall pooled grade ≥3 AEs rate was 38.2% (95% CI: 0.268–0.497) and was not influenced by whether ICI therapy was combined with other treatments or not or the treatment line.</p></sec><sec><title>Conclusion</title><p>Advanced BTC patients may benefit from ICI combination treatment without additional AEs. However, concurrent chemotherapy or radiotherapy is still needed to achieve better outcomes.</p></sec><sec><title>Systematic review registration</title><p><uri xlink:href="https://www.crd.york.ac.uk/prospero/" xmlns:xlink="http://www.w3.org/1999/xlink">https://www.crd.york.ac.uk/prospero/</uri>, identifier CRD42023452422.</p></sec>