<b>Comparative efficacy and safety of PD-1/PD-L1 Inhibitors versus platinum-based chemotherapy for the first-line treatment of advanced uroepithelial cancer: a systematic review and network meta-analysis</b>

Advanced uroepithelial carcinoma is a malignant tumour with high aggressiveness and recurrence tendency, which has a serious impact on the survival rate and quality of life of patients. Platinum-based combination chemotherapy is a treatment for metastatic uroepithelial cancer eligible for chemotherapy, and has made some progress in improving the survival rate of patients, however, the efficacy of these treatments is limited and often accompanied by serious toxic side effects. In recent years, immunotherapy has emerged as a novel treatment modality for advanced uroepithelial cancer. However, the efficacy and safety of immunotherapy in advanced uroepithelial cancer are still unclear, and many unknowns and challenges remain in clinical practice. The aim of this review is to evaluate the role of PD-1 inhibitors or PD-L1 inhibitors[PD-(L)1 inhibitors] as first-line treatment for mUC patients eligible for chemotherapy.进展期尿路上皮癌（advanced uroepithelial carcinoma）是一种侵袭性强、复发倾向显著的恶性肿瘤，严重影响患者的生存率与生活质量。铂类联合化疗是符合化疗指征的转移性尿路上皮癌（metastatic uroepithelial cancer, mUC）患者的治疗方案，在提升患者生存率方面已取得一定进展，但此类治疗的疗效有限，且常伴随严重的毒副反应。近年来，免疫治疗（immunotherapy）已成为进展期尿路上皮癌的新型治疗手段。然而，免疫治疗在进展期尿路上皮癌中的疗效与安全性仍不明确，临床实践中仍存在诸多未知与挑战。本综述旨在评估PD-1抑制剂（PD-1 inhibitor）或PD-L1抑制剂（PD-L1 inhibitor）[PD-(L)1抑制剂（PD-(L)1 inhibitor）]作为符合化疗指征的mUC患者的一线治疗方案的应用价值。