{"doi":"10.3389/fimmu.2024.1485303","title":"Efficacy and safety of PD-1/PD-L1 and CTLA-4 immune checkpoint inhibitors in the treatment of advanced colorectal cancer: a systematic review and meta-analysis","abstract":"<jats:sec><jats:title>Background</jats:title><jats:p>The efficacy and safety of PD-1/PD-L1 inhibitors combined with CTLA-4 inhibitors in the treatment of advanced colorectal cancer is controversial. This meta-analysis aimed to evaluate the efficacy and safety of PD-1/PD-L1 inhibitors combined with CTLA-4 inhibitors for advanced colorectal cancer.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>PubMed, Embase, the Cochrane Library, and Web of Science databases were systematically searched for relevant studies. Outcomes including median progression-free survival (mPFS), median overall survival (mOS), overall response rate (ORR), disease control rate (DCR), treatment-related adverse events (TRAEs) and ≥grade 3 TRAEs were extracted for further analysis. The risk of bias was assessed by subgroup analysis.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>12 articles with 566 patients were identified and subjected to meta-analysis. With regard to survival analysis, the pooled mOS and mPFS were 6.66 months (95%CI 4.85-9.16) and 2.92 months (95%CI 2.23-3.83), respectively. In terms of tumor response, the pooled ORR and DCR were 21% (95%CI 6%-41%) and 49% (95%CI 27%-71%), respectively. The pooled AEs rate and ≥ grade 3 AEs rate were 94% (95%CI 86%-99%) and 44% (95%CI 30%-58%).</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>PD-1/PD-L1 inhibitors combined with CTLA-4 inhibitors have shown promising clinical responses in the treatment of colorectal cancer (CRC). Although the incidence of adverse reactions is high, they are generally tolerable.</jats:p></jats:sec><jats:sec><jats:title>Systematic review registration</jats:title><jats:p><jats:uri>https://inplasy.com/</jats:uri>, identifier INPLASY202480030.</jats:p></jats:sec>","journal":"Frontiers in Immunology","year":2024,"id":642311,"datarank":0.515098080672772,"base_score":3.4339872044851463,"endowment":3.4339872044851463,"self_citation_contribution":0.515098080672772,"citation_network_contribution":0.0,"self_endowment_contribution":0.515098080672772,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":30,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1670565,"name":"Shufu Hou","orcid":null,"position":1,"is_corresponding":false},{"id":723350,"name":"Ning Ma","orcid":"0000-0001-7315-8835","position":2,"is_corresponding":false},{"id":1135102,"name":"Bing Yan","orcid":"0000-0003-3291-7721","position":3,"is_corresponding":false},{"id":1320053,"name":"Jing Gao","orcid":"0000-0002-7732-456X","position":4,"is_corresponding":false},{"id":1049652,"name":"Dandan Song","orcid":"0000-0002-5050-8211","position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Efficacy and safety of PD-1/PD-L1 and CTLA-4 immune checkpoint inhibitors in the treatment of advanced colorectal cancer: a systematic review and meta-analysis","abstract":"<jats:sec><jats:title>Background</jats:title><jats:p>The efficacy and safety of PD-1/PD-L1 inhibitors combined with CTLA-4 inhibitors in the treatment of advanced colorectal cancer is controversial. This meta-analysis aimed to evaluate the efficacy and safety of PD-1/PD-L1 inhibitors combined with CTLA-4 inhibitors for advanced colorectal cancer.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>PubMed, Embase, the Cochrane Library, and Web of Science databases were systematically searched for relevant studies. Outcomes including median progression-free survival (mPFS), median overall survival (mOS), overall response rate (ORR), disease control rate (DCR), treatment-related adverse events (TRAEs) and ≥grade 3 TRAEs were extracted for further analysis. The risk of bias was assessed by subgroup analysis.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>12 articles with 566 patients were identified and subjected to meta-analysis. With regard to survival analysis, the pooled mOS and mPFS were 6.66 months (95%CI 4.85-9.16) and 2.92 months (95%CI 2.23-3.83), respectively. In terms of tumor response, the pooled ORR and DCR were 21% (95%CI 6%-41%) and 49% (95%CI 27%-71%), respectively. The pooled AEs rate and ≥ grade 3 AEs rate were 94% (95%CI 86%-99%) and 44% (95%CI 30%-58%).</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>PD-1/PD-L1 inhibitors combined with CTLA-4 inhibitors have shown promising clinical responses in the treatment of colorectal cancer (CRC). Although the incidence of adverse reactions is high, they are generally tolerable.</jats:p></jats:sec><jats:sec><jats:title>Systematic review registration</jats:title><jats:p><jats:uri>https://inplasy.com/</jats:uri>, identifier INPLASY202480030.</jats:p></jats:sec>","is_dataset_classified":null,"base_score":0.0,"endowment":0.0,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"39555073","pmcid":"PMC11563947","openalex_id":null,"authors":[],"funders":[],"total_grants":0,"fwci":null,"citation_percentile":null,"influential_citations":0,"citation_trend":[],"oa_status":"gold","license":"cc-by","oa_locations":[{"url":"https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2024.1485303/pdf","host_type":"publisher"},{"url":"https://www.frontiersin.org/articles/10.3389/fimmu.2024.1485303/full","host_type":"publisher"},{"url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC11563947/pdf/fimmu-15-1485303.pdf","host_type":"repository"},{"url":"https://europepmc.org/articles/PMC11563947","host_type":"Europe_PMC"},{"url":"https://europepmc.org/articles/PMC11563947?pdf=render","host_type":"Europe_PMC"}],"fields_of_study":[],"mesh_terms":["Humans","Colorectal Neoplasms","Treatment Outcome","CTLA-4 Antigen","Programmed Cell Death 1 Receptor","B7-H1 Antigen","Immune Checkpoint Inhibitors"],"keywords":["Immunotherapy","CTLA-4","PD-L1","PD-1","Colorectal Cancer","Immune Checkpoint Inhibitors"],"sdg_mappings":[],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-07T22:17:49.565272Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}