anti-pd-1 monoclonal antibody as immune checkpoint inhibitor for newly diagnosed and recurrent glioblastoma: a systematic review and meta-analysis of randomized controlled trials

Monoclonal antibodies composed entirely of human immunoglobulin g4 that specifically target programmed death-1 (pd-1) are referred to as nivolumab and pembrolizumab. monoclonal antibody of anti-pd-1 type for glioblastoma was found to be beneficial and harmless in preclinical research. monoclonal antibody of anti-pd-1 (pembrolizumab, nivolumab) versus standard therapy for glioblastoma was systematically compared in terms of overall survival (os), progression-free survival (pfs), and adverse events (ae). pubmed, scopus, cochrane, and clinicaltrials.gov databases were systematically searched through may 2023 for phase i or later rcts reporting outcomes of interest. inclusion rcts criteria are adult population (>18 years old) with newly diagnosed or recurring cases of glioblastoma and have received immunotherapy with pd-1 inhibitors or standard treatment. for both os and pfs, pooled effects estimates were computed using the approach of cox proportional hazards regression. a computation was conducted on rcts comprising 1680 patients from 4 included studies. comparing anti-pd-1 monoclonal antibody to standard therapy, neither pfs nor os improved at the median (hr = 1.08, 95% ci = 0.87-1.34, p = 0.51; p = 0.29; p = 0.29; and p = 0.29, 95% ci = 0.85-1.74, respectively). furthermore, neither methylated nor un-methylated mgmt status benefits from anti-pd-1 monoclonal antibody (hr = 1.06, 95% ci = 0.89-1.27, p = 0.49; and hr = 1.29, 95% ci = 1.10-1.53, p = 0.002, respectively) in terms of overall survival. the anti-pd-1 antibody group experienced a greater incidence of ae (rr = 1.03, 95% ci = 0.94-1.14, p = 2.51). anti-pd-1 monoclonal antibody did not demonstrate any clinical advantage over standard treatment for glioblastoma, according to this meta-analysis of four rcts.