【摘要】 目的：评价PD-1/PD-L1抑制剂不同方式治疗妇科常见恶性肿瘤的疗效及安全性。方法：使用计算机检索CNKI、万方数据库、维普数据库、CBM、Pubmed、Web of science、Embase、Cochrane library中有关PD-1/PD-L1抑制剂治疗子宫颈癌、卵巢癌及子宫内膜癌的文献，并通过网页搜索clinical trials中相关临床试验。提取的数据包括中位总生存期(mOS)、中位无进展生存期(mPFS)和不良反应发生率。结果：共纳入10项RCTs,包含研究对象6077名。meta分析结果显示，总体疗效，PD-1/PD-L1抑制剂联合治疗分别相较于其对照组显著改善了患者的OS及PFS(PD-1/PD-L1抑制剂+贝伐珠单抗+化疗mOS:HR=0.78,95%CI 0.63～0.98、mPFS:HR=0.79,95%CI 0.64～0.98;PD-1/PD-L1抑制剂+化疗/放化疗mOS:HR=0.84,95%CI 0.71～0.99、mPFS:HR=0.84,95%CI 0.74～0.96)。安全性，PD-1/PD-L1抑制剂+化疗/放化疗相较于对照组显示出较高的不良反应发生率(AEs:RR=1.02,95%CI 1.01～1.04、grade≥3 AEs:RR=1.11,95%CI 1.04～1.18;TRAEs:RR=1.05,95%CI 1.00～1.10)。结论：PD-1/PD-L1抑制剂的疗效优于对照组，但安全性并无明显优势，其中PD-1/PD-L1抑制剂联合治疗可以显著提高患者的生存率，但增加了患者不良反应发生率，而PD-1/PD-L1抑制剂单药治疗相较于化疗对妇科恶性肿瘤患者无生存优势。更多还原

【Abstract】 Objective:To evaluate the efficacy and safety of PD-1/PD-L1 inhibitors through different approaches for treating patients with common gynecologic malignancies.Methods:A computerized search of the literatures related to PD-1/PD-L1 inhibitors through different approaches for treating the patients with cervical cancer,ovarian cancer or endometrial carcinoma in the data bases,such as CNKI,Wanfang Database,VIP Database,CBM,Pubmed,Web of Science,Embase,and Cochrane Library was conducted.Clinical Trials.gov was also searched for the relevant clinical trials.The extracted data of the patients included the median overall survival(mOS),median progression-free survival(mPFS) and adverse event rate.Results:A total of 10 randomized controlled trial(RCTs) involving 6077 patients were included in this meta-analysis,and the results showed that compared to the other treatments of the patients,such as PD-1/PD-L1 inhibitor combined with bevacizumab and chemotherapy(mOS:HR=0.78,95%CI 0.63-0.98,mPFS:HR=0.79,95 % CI0.64-0.98) and PD-1/PD-L1 inhibitor combined with chemotherapy/radiotherapy(mOS:HR=0.84,95%CI 0.71-0.99,mPFS:HR=0.84,95%CI 0.74-0.96),the combined PD-1/PD-L1 inhibitors improved mOS and PFS of the patients significantly.The safety analysis indicated that compared to the other treatment,such as PD-1/PD-L1 inhibitor combined with bevacizumab and chemotherapy(AEs:RR=1.02,95%CI 1.01-1.04,grade≥3) and PD-1/PD-L1 inhibitor combined with chemotherapy/radiotherapy(AEs:RR=1.11,95%CI 1.04-1.18,TRAEs:RR=1.05,95%CI 1.00-1.10),the combined PD-1/PD-L1 inhibitors increased the adverse event rate.Conclusion:The PD-1/PD-L1 inhibitors for treating the patients with common gynecologic malignancies has better efficacy than that of the other treatments,but there is no obvious advantage in the treatment safety.The combination treatment of PD-1/PD-L1 inhibitors for treating the patients with common gynecologic malignancies can significantly increase their survival rate,but also increase the incidence of their adverse events.The PD-1/PD-L1 inhibitor monotherapy does not confer the survival advantage of the patients with common gynecologic malignancies compared to the chemotherapy.更多还原