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Zhou G.-W.,Second Military Medical University | Xiong Y.,Second Military Medical University | Chen S.,Second Military Medical University | Xia F.,Hospital of Peoples Liberation Army | And 2 more authors.
Medicine (United States) | Year: 2016

Background: Anti-PD-1/PD-L1 antibody therapy is a promising clinical treatment for nonsmall-cell lung cancer (NSCLC). However, whether anti-PD-1/PD-L1 antibody therapy can provide added benefits for heavily pretreated patients with advanced NSCLC and whether the efficacy of anti-PD-1/PD-L1 antibody therapy relates to the tumor PD-L1 expression level remain controversial. Thus, this meta-analysis evaluated the efficacy and safety of anti-PD-1/PD-L1 antibody therapy for pretreated patients with advanced NSCLC. Methods: Randomized clinical trials were retrieved by searching the PubMed, EMBASE, ASCO meeting abstract, clinicaltrial.gov, and Cochrane library databases. The pooled hazard ratios (HRs) for overall survival (OS) and progression-free survival (PFS), and odds ratios for the overall response rate and adverse events (AEs) were calculated by STATA software. Results: Three randomized clinical trials involving 1141 pretreated patients with advanced NSCLC were included. These trials all compared the efficacy and safety of anti-PD-1/PD-L1 antibodies (nivolumab and MPDL3280A) with docetaxel. The results suggested that, for all patients, anti-PD-1/PD-L1 therapy could acquire a greater overall response (odds ratio=1.50, 95% CI: 1.08-2.07, P=0.015, P for heterogeneity [Ph]=0.620) and longer OS (HR=0.71, 95% CI: 0.61-0.81, P<0.001, Ph=0.361) than docetaxel, but not PFS (HR=0.83, 95% CI: 0.65-1.06, P=0.134; Ph=0.031). Subgroup analyses according to the tumor PD-L1 expression level showed that anti-PD-1/PD-L1 therapy could significantly improve both OS and PFS in patients with high expressions of PD-L1, but not in those with low expressions. Generally, the rates of grade 3 or 4 AEs of anti-PD-1/PD-L1 therapy were significantly lower than that of docetaxel. However, the risks of pneumonitis and hypothyroidism were significantly higher. Conclusion: Anti-PD-1/PD-L1 antibody therapy may significantly improve the outcomes for pretreated advanced NSCLC patients, with a better safety profile than docetaxel. Copyright © 2016 the Author(s). Published by Wolters Kluwer Health, Inc. All.


Zhang C.,First Affiliated Hospital to PLA General Hospital | Huang D.,First Affiliated Hospital to PLA General Hospital | Shen D.,First Affiliated Hospital to PLA General Hospital | Zhang L.,First Affiliated Hospital to PLA General Hospital | And 3 more authors.
International Journal of Clinical and Experimental Medicine | Year: 2015

Objective: To explore the influence of BNP (Brain Natriuretic Peptide) in plasma on the long-term cause of mortality and prognosis of patients with cardiovascular disease (CVD). Method: We performed a retrospective cohort study of 276 inpatients that enrolled in our hospital from March 2003 to December 2004 and had a history of heart disease and received a BNP test. Kaplan-Meier survival curves with Log-Rank test were used to compare the survival rates among different levels of BNP (<100 ng/L, 101~1000 ng/L, 1001~5000 ng/L and >5000 ng/L). Cox proportional hazards regression models were used to estimate HRs and 95% CIs with adjustments for other covariance’s. Result: After a median follow-up of 7 years, a total of 91 patients died of whom fifty were cardiogenic deaths and 41 were non-cardiogenic. The survival rates were of statistical significance (P=0.0000) between the different levels of BNP in the 4 groups, and the mortality rate increased gradually with the increase in BNP concentration. Multivariable Cox regression analysis showed that BNP levels were inversely associated with the survival rate in CVD patients (HR=0.24, 95% CI: 0.13~0.42). In addition, age and left ventricular ejection fraction values were also of statistical significance in the Cox regression model. Conclusion: Our findings suggested that high Plasma BNP levels may have an adverse effect on the prognosis of patients with cardiovascular disease. © 2015, E-Century Publishing Corporation. All rights reserved.

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