尽管在原发性黑色素瘤的治疗方面取得了进展，但黑色素瘤脑转移对癌症治疗提出了重大挑战，并降低了总体生存率。靶向 PD-1/PD-L1 通路的免疫检查点抑制剂 (ICIs) 在治疗晚期黑色素瘤方面显示出前景，但其对黑色素瘤脑转移的疗效仍存在争议。本系统综述和荟萃分析总结了抗 PD-1/PD-L1 抑制剂治疗黑色素瘤脑转移的证据。本系统评价和荟萃分析遵循 PRISMA 指南。 PICO 标准针对接受 PD-1/PD-L1 抑制剂治疗的黑色素瘤脑转移患者，评估总生存期、无进展生存期和并发症。纳入标准是针对人类使用 PD-1/PD-L1 抑制剂治疗黑色素瘤脑转移的英国研究，涉及 10 名以上的患者。总共 22 项试验涉及 1523 名接受抗 PD-1/PD-L1 抑制剂治疗的黑色素瘤脑转移患者。 我们的研究结果显示，6 个月 OS 率为 0.75 [95%CI：0.67-0.84]，6 个月 PFS 率为 0.42 [95%CI：0.31-0.52]，1 年 OS 率为 0.63 [95% CI：0.52-0.74]，1 年 PFS 率为 0.45 [95%CI：0.32-0.58]，18 个月 OS 率为 0.52 [95%CI：0.37-0.67]，2 年 OS 率为50% [95% CI: (34%-65%)]，2 年 PFS 率为 0.36 (95% CI:0.23-0.50)，3 年 OS 率为 0.42 (95% CI:0.17-0.67) ，4 年 PFS 率为 0.35 [95%CI：0.08-0.61]，4 年 OS 率为 0.29 [95%CI：0.01-0.56]，5 年 OS 率为 0.29（95%CI： 0.09-0.50），5 年 PFS 率为 0.11（95%CI：0.03-0.19）。综合疾病稳定率为0.13[95%CI:0.05-0.20]，疾病进展率为0.49[95%CI:0.37-0.62]，部分缓解率为0.14[95%CI:0.07-0.20]，对象缓解率为 0.35 [95%CI:0.24-0.46]，完全缓解率为 0.22 [95%CI:0.12-0.32]。总之，我们的荟萃分析提供了令人信服的证据，支持 PD-1/PD-L1 抑制剂对黑色素瘤脑肿瘤患者的疗效，良好的生存结果和疾病控制率证明了这一点。© 2024。作者，下获得 Springer-Verlag GmbH 德国（Springer Nature 旗下公司）的独家许可。

Melanoma brain metastases present a major challenge in cancer treatment and reduce overall survival despite advances in managing primary melanoma. Immune checkpoint inhibitors (ICIs) that target PD-1/PD-L1 pathways have shown promise in treating advanced melanoma, but their efficacy for melanoma brain metastases is debated. This systematic review and meta-analysis summarize evidence on anti-PD-1/PD-L1 inhibitors for melanoma brain metastases. This systematic review and meta-analysis followed PRISMA guidelines. PICO criteria targeted melanoma brain metastasis patients treated with PD-1/PD-L1 inhibitors, assessing overall survival, progression-free survival, and complications. Inclusion criteria were English studies on humans using PD-1/PD-L1 inhibitors for melanoma brain metastases with > 10 patients. A total of 22 trials involving 1523 melanoma brain metastase patients treated with anti-PD-1/PD-L1 inhibitors were thoroughly analyzed. Our findings show the 6-month OS rate of 0.75 [95%CI:0.67-0.84], the 6-months PFS rate of 0.42 [95%CI:0.31-0.52], the 1-year OS rate of 0.63 [95%CI:0.52-0.74], the 1-year PFS rate was 0.45 [95%CI:0.32-0.58], the 18-months OS rate of 0.52 [95%CI:0.37-0.67], the 2-year OS rate of 50% [95% CI: (34%-65%)], the 2 year PFS rate of 0.36 (95%CI:0.23-0.50), the 3-year OS rate of 0.42 (95%CI:0.17-0.67), the 4-year PFS rate of 0.35 [95%CI:0.08-0.61], the 4-year OS rate of 0.29 [95%CI:0.01-0.56], the 5-year OS rate of 0.29 (95%CI:0.09-0.50), and the 5-year PFS rate of 0.11 (95%CI:0.03-0.19). The combined disease stability rate was 0.13 [95%CI:0.05-0.20], the progressive disease rate was 0.49 [95%CI:0.37-0.62], the partial response rate was 0.14 [95%CI:0.07-0.20], the object response rate was 0.35 [95%CI:0.24-0.46], and the complete response rate was 0.22 [95%CI:0.12-0.32]. In conclusion, our meta-analysis provides compelling evidence supporting the efficacy of PD-1/PD-L1 inhibitors in patients with melanoma brain tumors, as evidenced by favorable survival outcomes and disease control rates.© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.