Background/Objectives: Camptothecin (CPT) and its derivatives, irinotecan and topotecan, are integral components of cancer chemotherapy, often used in combination therapies. This meta-analysis evaluates the efficacy of CPT-based combination treatments in cancer patients.Methods: We systematically searched the literature database using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist for articles published between 2000 and 2022. Published studies were retrieved through an electronic search on the Web of Science, PubMed, and Google Scholar databases. A total of 138 studies were downloaded and examined, and 71 eligible studies were selected for meta-analysis after excluding studies that did not meet the inclusion criteria.Results: Ultimately, a total of 71 studies were included in the analysis, comprising non-small cell lung cancer (NSCLC), colorectal cancer (COLRC), oesophageal/gastric cancer (O/GC), and small cell lung cancer (SCLC). For NSCLC, the objective response rate (RR) was 31.8% (95% CI: 27.3–37.1%,p= 0.025), with irinotecan plus cisplatin showing significantly higher efficacy compared to other irinotecan-based combinations. In COLRC, irinotecan and 5-fluorouracil/leucovorin plus bevacizumab demonstrated superior efficacy with a RR of 44% (95% CI: 34–58,p< 0.001) and minimal haematological toxicity. In O/GC, irinotecan-based combinations showed an average RR of 43% (95% CI: 27–70,p< 0.001) and average overall survival (OS) and progression-free survival (PFS) rates of 10.2 and 5.5 months, respectively. For SCLC, irinotecan-based combinations had a higher control response than topotecan-based ones, while the latter exhibited higher rates of stable and progressive disease. The overall RR for SCLC was 45% (95% CI: 34.3–60.2,p< 0.001).Conclusions: The existing evidence underscored the potential of CPT-based combination therapy in various cancers. Among the various combinations discussed in this analysis, irinotecan plus cisplatin demonstrated the highest objective RR in 12 trials focused on NSCLC. This study provides valuable insights into potential treatment strategies for various types of cancer, emphasising the importance of personalised and tailored approaches to maximise efficacy and minimise adverse effects.
背景/目的：喜树碱（CPT）及其衍生物伊立替康和拓扑替康是癌症化疗的重要组成部分，常被用于联合治疗方案。本荟萃分析旨在评估基于CPT的联合疗法在癌症患者中的疗效。 方法：我们采用系统综述与荟萃分析优先报告条目清单，系统检索了2000年至2022年间发表的文献。通过Web of Science、PubMed和Google Scholar数据库进行电子检索，共下载并审查了138项研究，在排除不符合纳入标准的研究后，最终筛选出71项符合条件的研究进行荟萃分析。 结果：分析共纳入71项研究，涵盖非小细胞肺癌（NSCLC）、结直肠癌（COLRC）、食管/胃癌（O/GC）和小细胞肺癌（SCLC）。对于NSCLC，客观缓解率（RR）为31.8%（95% CI：27.3–37.1%，p=0.025），其中伊立替康联合顺铂方案相较于其他基于伊立替康的联合方案显示出显著更高的疗效。在COLRC中，伊立替康联合5-氟尿嘧啶/亚叶酸钙及贝伐珠单抗方案表现出更优疗效，RR达44%（95% CI：34–58，p<0.001），且血液学毒性最小。对于O/GC，基于伊立替康的联合方案平均RR为43%（95% CI：27–70，p<0.001），平均总生存期（OS）和无进展生存期（PFS）分别为10.2个月和5.5个月。在SCLC中，基于伊立替康的联合方案较基于拓扑替康的方案具有更高的疾病控制率，而后者显示出更高的疾病稳定和进展率。SCLC的总体RR为45%（95% CI：34.3–60.2，p<0.001）。 结论：现有证据强调了基于CPT的联合疗法在多种癌症中的潜力。在本分析讨论的各种联合方案中，伊立替康联合顺铂在12项针对NSCLC的试验中显示出最高的客观缓解率。本研究为各类癌症的潜在治疗策略提供了有价值的见解，强调了个体化与定制化治疗方案对于最大化疗效并最小化不良反应的重要性。
肿瘤(癌症)患者之家