hepatoАнналы хирургической гепатологииAnnaly khirurgicheskoy gepatologii = Annals of HPB Surgery1995-54642408-9524НЭИКОН ИСП10.16931/1995-5464.2024-3-124-132hepato-1143Research ArticleОБЗОР ЛИТЕРАТУРЫREVIEWSВыживаемость при таргетной химиотерапии нерезектабельных злокачественных новообразований желчевыводящей системы (систематический обзор и метаанализ)Survival after targeted chemotherapy and unresectable biliary malignancies (systematic review and meta-analysis)https://orcid.org/0000-0002-1199-3699ЦеймахА. Е.TseimakhA. E.

Цеймах Александр Евгеньевич – канд. мед. наук, доцент кафедры факультетской хирургии им. профессора  И.И. Неймарка с курсом дополнительного профессионального образования

656038, Барнаул, пр. Ленина, д. 40

Alexander E. Tseimakh – Cand. of Sci. (Med.), Associate Professor, Department of Faculty Surgery named after Professor I.I. Neimark with a course of Advanced Professional Education

40, Lenina ave., Barnaul, 656038

alevtsei@rambler.ruhttps://orcid.org/0000-0001-5632-845XМищенкоА. Н.MitshhenkoA. N.

Мищенко Александр Николаевич – заведующий отделением рентгенхирургических методов диагностики и лечения

656045, Барнаул, Змеиногорский тракт, д. 75

Alexander N. Mitshhenko – Head of the Department of X-ray Surgical Methods of Diagnosis and Treatment

75, Zmeinogorsky tract, Barnaul, 656045

mi-ross@mail.ruhttps://orcid.org/0000-0002-5253-4325ШойхетЯ. Н.ShoikhetYa. N.

Шойхет Яков Нахманович – доктор мед. наук, профессор, член-корреспондент РАН, профессор кафедры факультетской хирургии им. профессора И.И. Неймарка с курсом дополнительного профессионального образования

656038, Барнаул, пр. Ленина, д. 40

Yakov N. Shoikhet – Doct. of Sci. (Med.), Professor, Corresponding Member of the Russian Academy of Sciences, Professor, Department of Faculty Surgery named after Professor I.I. Neimark with a course of Advanced Professional Education

40, Lenina ave., Barnaul, 656038

starok100@mail.ruФГБОУ ВО “Алтайский государственный медицинский университет”РоссияAltai State Medical UniversityRussian FederationГБУЗ “Городская больница №5, г. Барнаул”РоссияCity Hospital №5Russian Federation202430092024293124132Copyright © Цеймах А.Е., Мищенко А.Н., Шойхет Я.Н., 20242024Цеймах А.Е., Мищенко А.Н., Шойхет Я.Н.Tseimakh A.E., Mitshhenko A.N., Shoikhet Y.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://hepato.elpub.ru/jour/article/view/1143Цель

Цель. Оценка выживаемости пациентов с нерезектабельными злокачественными новообразованиями желче-выводящей системы при таргетной химиотерапии для выявления наиболее перспективных адъювантных схем. Материал и методы. Рассматривали публикации в базах PubMed Central, РИНЦ, Cochrane. Гетерогенность оценивали графически (блобограммы) и статистически (τ2 и I2 ).

Результаты

Результаты. Метаанализ пятилетней выживаемости выявил большую объединенную оценку периода в основных группах, в которых применяли таргетную химиотерапию, – 295 ± 71 день (95% ДИ 144–408; p < 0,001) по сравнению с группами сравнения – 205 ± 81 день (95% ДИ 81–426; p < 0,001). Гетерогенность исследований была признана умеренной (I2 = 0%, p = 0,06). Значимых публикационных ошибок и предвзятости в обоих метаанализах не выявлено.

Заключение

Заключение. Таргетная химиотерапия увеличивает общую выживаемость больных нерезектабельными злокачественными новообразованиями желчных протоков. Наилучшую эффективность показала системная химиотерапия на основе гемцитабина и цисплатина с добавлением селективного ингибитора мутации IDH-1 ивосидениба.

Aim

Aim. To evaluate the survival rate of patients with unresectable biliary malignancies under targeted chemotherapy in order to identify the most promising adjuvant regimens.

Materials and methods

Materials and methods. The study involves publications in PubMed Central, RSCI, and Cochrane databases. Heterogeneity was assessed graphically (blobograms) and statistically (τ 2 and I2 ).

Results

Results. Meta-analysis of five-year survival revealed a greater pooled estimate of the period in the main groups treated with targeted chemotherapy – 295 ± 71 days (95% CI 144–408; p <0.001) against comparison groups – 205 ± 81 days (95% CI 81–426; p <0.001). Study heterogeneity was considered moderate (I2 = 0%, p = 0.06). No significant publication errors and biases were revealed in both meta-analyses.

Conclusion

Conclusion. Targeted chemotherapy increases the overall survival of patients with unresectable malignancies of the bile ducts. Systemic chemotherapy based on gemcitabine and cisplatin with addition of ivosidenib, a selective inhibitor of mutant IDH1, showed the best efficacy.

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The authors declare that there are no conflicts of interest present.