【摘要】 目的探讨实体器官移植(SOT)术后使用程序性细胞死亡受体-1(PD-1)单克隆抗体(单抗治疗恶性肿瘤的有效性和安全性。方法检索7个数据库中的相关文献。收集54例SOT受者术后使用PD-1单抗治疗恶性肿瘤的案例,对使用PD-1单抗的SOT受者的临床效果及排斥反应情况进行分析。结果共纳入符合标准的文献32篇,共54例SOT受者。其中男43例,女11例,年龄为14～79岁。包括29例肾移植受者、19例肝移植受者、6例心脏移植受者。SOT受者使用的PD-1单抗药物类型包括28例使用派姆单抗、26例使用纳武单抗。PD-1单抗治疗SOT受者术后恶性肿瘤的总体缓解率为32%(17/54),疾病进展率44%(24/54),病死率为36%(19/54)。PD-1单抗治疗SOT受者术后恶性肿瘤后,排斥反应发生率为39%(21/54)。排斥反应与PD-1单抗药物类型无明显相关性(P>0.05)。结论 PD-1单抗能有效治疗SOT受者术后恶性肿瘤,治疗过程中可引发排斥反应,但排斥反应并不是导致受者死亡的最常见原因。更多还原

【Abstract】 Objective To investigate the efficacy and safety of programmed cell death protein-1(PD-1) monoclonal antibody on the treatment of malignant tumor after solid organ transplantation(SOT). Methods The relevant literatures in 7 databases were searched. The data on 54 cases of recipients with malignant tumors treated with PD-1 monoclonal antibody after SOT were collected, and the clinical effects and rejection of SOT recipients treated with PD-1 monoclonal antibody were analyzed. Results Total 32 acceptable articles including 54 SOT recipients were incorporated, including 43 males and 11 females aged 14-79 years old. There are 29 renal transplant recipients, 19 liver transplant recipients and 6 heart transplant recipients. The types of PD-1 monoclonal antibody agent used by SOT recipients included pembrolizumab for 28 patients and nivolumab for 26 patients. The overall remission rate, disease progression rate and fatality rate of PD-1 monoclonal antibody for postoperative malignant tumors of SOT recipients were 32%(17/54), 44%(24/54) and 36%(19/54), respectively. After treatment with PD-1 monoclonal antibody for postoperative malignant tumors of SOT recipients, the incidence of rejection was 39%(21/54), indicating no significant correlation between rejection and type of PD-1 monoclonal antibody(P>0.05). Conclusions PD-1 monoclonal antibody can effectively treat postoperative malignant tumors of SOT recipients, and may induce rejection during the treatment. But rejection is not the most common cause for death of recipients.更多还原