PD-1/PD-L1 inhibitors combined with chemotherapy as first-line treatment for advanced biliary tract cancer: a systematic review and meta-analysis
PD-1/PD-L1 inhibitors plus chemotherapy significantly improves survival outcomes and objective response rate in advanced BTC without increasing severe adverse event risk.
This systematic review and meta‑analysis evaluated the efficacy and safety of PD‑1/PD‑L1 inhibitors plus chemotherapy as first‑line therapy for advanced biliary tract cancer (BTC). Five randomized controlled trials (including two phase III studies) and six retrospective studies were included. The combination significantly improved overall survival (HR 0.80, 95% CI 0.72–0.89), progression‑free survival (HR 0.81, 95% CI 0.71–0.93), and objective response rate (RR 1.38, 95% CI 1.02–1.87) without increasing the risk of severe adverse events. The results support the use of PD‑1/PD‑L1 inhibitors plus chemotherapy as a superior first‑line treatment for advanced BTC.
The findings demonstrate that adding PD‑1/PD‑L1 checkpoint inhibition to standard gemcitabine‑based chemotherapy enhances survival and tumor response in patients with advanced biliary tract cancer, a disease with historically poor outcomes, while maintaining a manageable safety profile.
Evidence level: Számítógépes vagy elméleti. Modellből vagy adatbányászatból származó jel.
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