{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T07:59:29Z","timestamp":1790755169354,"version":"4.1.0"},"reference-count":35,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:00:00Z","timestamp":1790726400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:00:00Z","timestamp":1790726400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100011827","name":"Guangxi Medical University","doi-asserted-by":"publisher","award":["GKE\u2010ZZ202506"],"award-info":[{"award-number":["GKE\u2010ZZ202506"]}],"id":[{"id":"10.13039\/501100011827","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82460536"],"award-info":[{"award-number":["82460536"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the efficacy and safety of PD\u20101\/PD\u2010L1 inhibitors plus small\u2010molecule anti\u2010angiogenic drugs (apatinib, anlotinib and famitinib) for recurrent\/metastatic nasopharyngeal carcinoma (R\/M NPC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Systematic searches of major databases up to January 7, 2026 identified prospective single\u2010arm Phase II trials and retrospective cohort\/real\u2010world studies of PD\u20101\/PD\u2010L1 inhibitors combined with apatinib, anlotinib, or famitinib in R\/M NPC. Pooled response and safety rates were estimated using random\u2010effects models, with study quality assessed by appropriate tools.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Nine studies comprising 10 independent cohorts (357 patients) were included. The pooled objective response rate (ORR) was 48% (95% CI: 39%\u201357%), the disease control rate (DCR) 83% (95% CI: 77%\u201388%), and the 1\u2010year overall survival rate 79% (95% CI: 68%\u201386%). The incidence of grade \u2265\u20093 treatment\u2010related adverse events (TRAEs) was 47% (95% CI: 37%\u201358%). The most frequent serious TRAEs were hypertension (9%), hand\u2010foot syndrome (10%), and nasopharyngeal necrosis (14%), with the latter requiring close monitoring due to its potential for severe bleeding complications. No treatment\u2010related deaths were reported across all included studies. Subgroup analysis showed no significant difference in ORR between camrelizumab and toripalimab; apatinib yielded higher ORR than anlotinib; immunotherapy\u2010naive patients had significantly higher ORR than those previously treated with immune checkpoint inhibitors (ICIs) (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0028).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The combination shows promising antitumor activity and a generally acceptable safety profile in R\/M NPC, particularly for immunotherapy\u2010naive patients. These findings support further investigation in well\u2010designed randomized controlled trials, but confirmation of its role relative to standard therapies requires larger comparative studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cam4.72340","type":"journal-article","created":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T07:20:56Z","timestamp":1790752856000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy and Safety of\n                    <scp>PD<\/scp>\n                    \u20101\/\n                    <scp>PD<\/scp>\n                    \u2010\n                    <scp>L1<\/scp>\n                    Inhibitors Combined With Anti\u2010Angiogenic Tyrosine Kinase Inhibitors for Recurrent or Metastatic Nasopharyngeal Carcinoma: A Systematic Review and Single\u2010Arm Meta\u2010Analysis"],"prefix":"10.1002","volume":"15","author":[{"given":"Rongyi","family":"Hu","sequence":"first","affiliation":[{"name":"Department of Radiotherapy The Affiliated Tumor Hospital of Guangxi Medical University  Nanning Guangxi Autonomous Region People's Republic of China"},{"name":"Guangxi Key Laboratory of High\u2010Incidence Tumor Prevention and Treatment Guangxi Medical University  Nanning Guangxi China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-3186-2709","authenticated-orcid":false,"given":"Tiebin","family":"Li","sequence":"additional","affiliation":[{"name":"Army Medical University  Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ziman","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy The Affiliated Tumor Hospital of Guangxi Medical University  Nanning Guangxi Autonomous Region People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huining","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy The Affiliated Tumor Hospital of Guangxi Medical University  Nanning Guangxi Autonomous Region People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-1276-3714","authenticated-orcid":false,"given":"Song","family":"Qu","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy The Affiliated Tumor Hospital of Guangxi Medical University  Nanning Guangxi Autonomous Region People's Republic of China"},{"name":"Guangxi Key Laboratory of High\u2010Incidence Tumor Prevention and Treatment Guangxi Medical University  Nanning Guangxi China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,30]]},"reference":[{"issue":"10192","key":"e_1_2_11_2_1","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1016\/S0140-6736(19)30956-0","article-title":"Nasopharyngeal Carcinoma","volume":"394","author":"Chen Y. 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