Eficácia e segurança dos inibidores da PD-1/PD-L1 mais quimioterapia ± bevacizumab para o câncer do colo do útero recorrente ou metastático: uma revisão sistemática e metanálise de ensaios controlados randomizados

Resumo original em inglês

O que aconteceu

The efficacy of adding PD-1/PD-L1 inhibitors to chemotherapy ± bevacizumab in recurrent or metastatic cervical cancer is under active investigation.

To systematically evaluate the efficacy and safety of PD-1/PD-L1 inhibitors combined with chemotherapy ± bevacizumab in this setting through a meta-analysis of randomized controlled trials (RCTs).

A systematic search of PubMed, Embase, Web of Science, Cochrane Library, Scopus, and ClinicalTrials.gov was conducted for RCTs published up to January 14, 2026. Primary outcomes were overall survival (OS) and progression-free survival (PFS); hazard ratios (HRs) were derived from reconstructed Kaplan-Meier curves.

https://www.crd.york.ac.uk/PROSPERO/view/, identifier CRD420261472748.

O que encontraram

Six RCTs involving 2,242 patients were included: 1,131 received PD-1/PD-L1 inhibitors plus chemotherapy ± bevacizumab, and 1,111 received chemotherapy ± bevacizumab alone. The combination regimen significantly prolonged median OS (28.7 vs. 19.4 months) and median PFS (12.0 vs. 8.7 months). Pooled risk ratios (RRs) for complete response, partial response, stable disease, progressive disease, and objective response rate were 1.606 (95% CI, 1.333-1.936), 1.127 (95% CI, 0.994-1.277), 0.733 (95% CI, 0.612-0.878), 0.460 (95% CI, 0.305-0.695), and 1.235 (95% CI, 1.153-1.322), respectively. The risk of any-grade adverse events did not differ significantly between groups (RR 0.999, 95% CI 0.991-1.008), whereas the combination was associated with an increased risk of grade ≥3 adverse events (RR 1.069, 95% CI 1.019-1.121). Frequently reported adverse reactions included nausea, anemia, constipation, arthralgia, neutropenia, hypertension, alopecia, and peripheral neuropathy.

Por que isso importa

In patients with recurrent or metastatic cervical cancer, the addition of PD-1/PD-L1 inhibitors to chemotherapy ± bevacizumab significantly improves OS and PFS, though with a modest increase in high-grade toxicity.

Resumo publicado sob licença CC BY. A tradução para o português ainda não chegou a este estudo.