CHKA and anemia: The subgroup meta-analysis indicated that CKI plus PBC could significantly reduce adverse reactions, such as nausea and vomiting, leukopenia, thrombocytopenia, hemoglobin, stomatitis, diarrhea, hair loss, and anemia, etc. Our results demonstrated that CKI combined with PBC was associated with a significant improvement in QOL (P < 0.00001), suggesting that combined treatment increases the tolerance to chemotherapy.