Comparative efficacy of chemoimmunotherapy versus immunotherapy for advanced non-small cell lung cancer : A network meta-analysis of randomized trials
© 2020 American Cancer Society..
BACKGROUND: To the authors' knowledge, in the absence of head-to-head trials, it is unclear whether chemoimmunotherapy provides an additional overall survival (OS) benefit compared with immunotherapy alone in the first-line treatment of patients with advanced non-small cell lung cancer (NSCLC). The authors conducted a systematic literature review and network meta-analysis (NMA) to compare the efficacy of chemoimmunotherapy versus ICI.
METHODS: MEDLINE, Excerpta Medica dataBASE (EMBASE), Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov were searched from inception to April 2020. Phase 3 trials evaluating the efficacy of first-line ICI or chemoimmunotherapy and reporting efficacy outcomes (OS, progression-free survival [PFS], and the overall response rate [ORR]) stratified by programmed death-ligand 1 (PD-L1) status were included. NMA with a Bayesian random effects model was performed.
RESULTS: A total of 12 eligible trials comprising 7845 patients were included. In patients who were negative for PD-L1 (tumor proportion score [TPS] <1%), NMA comparing chemoimmunotherapy with dual-agent ICI failed to demonstrate a statistically significant difference with regard to OS, PFS, or the ORR. In patients with low PD-L1 (TPS 1%-49%), there was no statistically significant difference observed between chemoimmunotherapy compared with either single-agent ICI or dual-agent ICI with regard to OS or the ORR. In patients with high PD-L1 (TPS ≥50%), chemoimmunotherapy was found to be associated with an improved PFS and ORR compared with single-agent ICI, but not with dual-agent ICI. No differences in OS were observed with chemoimmunotherapy when compared with either single-agent or dual-agent ICIs.
CONCLUSIONS: Although chemoimmunotherapy appears to improve the ORR and PFS in patients with PD-L1-high tumors when compared with single-agent ICI, it does not appear to confer an OS benefit over single-agent or dual-agent ICI for patients with advanced NSCLC regardless of PD-L1 status. Prospective trials are needed to validate these findings.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2021 |
|---|---|
| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:127 |
|---|---|
| Enthalten in: |
Cancer - 127(2021), 5 vom: 01. März, Seite 709-719 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Pathak, Ranjan [VerfasserIn] |
|---|
| Links: |
|---|
| Anmerkungen: |
Date Completed 15.10.2021 Date Revised 15.10.2021 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1002/cncr.33269 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM316877387 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM316877387 | ||
| 003 | DE-627 | ||
| 005 | 20231225162031.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2021 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1002/cncr.33269 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1056.xml |
| 035 | |a (DE-627)NLM316877387 | ||
| 035 | |a (NLM)33119177 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Pathak, Ranjan |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Comparative efficacy of chemoimmunotherapy versus immunotherapy for advanced non-small cell lung cancer |b A network meta-analysis of randomized trials |
| 264 | 1 | |c 2021 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 15.10.2021 | ||
| 500 | |a Date Revised 15.10.2021 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2020 American Cancer Society. | ||
| 520 | |a BACKGROUND: To the authors' knowledge, in the absence of head-to-head trials, it is unclear whether chemoimmunotherapy provides an additional overall survival (OS) benefit compared with immunotherapy alone in the first-line treatment of patients with advanced non-small cell lung cancer (NSCLC). The authors conducted a systematic literature review and network meta-analysis (NMA) to compare the efficacy of chemoimmunotherapy versus ICI | ||
| 520 | |a METHODS: MEDLINE, Excerpta Medica dataBASE (EMBASE), Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov were searched from inception to April 2020. Phase 3 trials evaluating the efficacy of first-line ICI or chemoimmunotherapy and reporting efficacy outcomes (OS, progression-free survival [PFS], and the overall response rate [ORR]) stratified by programmed death-ligand 1 (PD-L1) status were included. NMA with a Bayesian random effects model was performed | ||
| 520 | |a RESULTS: A total of 12 eligible trials comprising 7845 patients were included. In patients who were negative for PD-L1 (tumor proportion score [TPS] <1%), NMA comparing chemoimmunotherapy with dual-agent ICI failed to demonstrate a statistically significant difference with regard to OS, PFS, or the ORR. In patients with low PD-L1 (TPS 1%-49%), there was no statistically significant difference observed between chemoimmunotherapy compared with either single-agent ICI or dual-agent ICI with regard to OS or the ORR. In patients with high PD-L1 (TPS ≥50%), chemoimmunotherapy was found to be associated with an improved PFS and ORR compared with single-agent ICI, but not with dual-agent ICI. No differences in OS were observed with chemoimmunotherapy when compared with either single-agent or dual-agent ICIs | ||
| 520 | |a CONCLUSIONS: Although chemoimmunotherapy appears to improve the ORR and PFS in patients with PD-L1-high tumors when compared with single-agent ICI, it does not appear to confer an OS benefit over single-agent or dual-agent ICI for patients with advanced NSCLC regardless of PD-L1 status. Prospective trials are needed to validate these findings | ||
| 650 | 4 | |a Comparative Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a combination | |
| 650 | 4 | |a drug therapy | |
| 650 | 4 | |a immunotherapy | |
| 650 | 4 | |a meta-analysis | |
| 650 | 4 | |a network | |
| 650 | 4 | |a non-small cell lung carcinoma | |
| 650 | 4 | |a programmed cell death protein 1 receptor/antagonists and inhibitors | |
| 650 | 4 | |a survival analysis | |
| 650 | 4 | |a systematic review | |
| 650 | 7 | |a B7-H1 Antigen |2 NLM | |
| 650 | 7 | |a CD274 protein, human |2 NLM | |
| 650 | 7 | |a Immune Checkpoint Inhibitors |2 NLM | |
| 700 | 1 | |a De Lima Lopes, Gilberto |e verfasserin |4 aut | |
| 700 | 1 | |a Yu, Han |e verfasserin |4 aut | |
| 700 | 1 | |a Aryal, Madan Raj |e verfasserin |4 aut | |
| 700 | 1 | |a Ji, Wenyan |e verfasserin |4 aut | |
| 700 | 1 | |a Frumento, Katherine Stemmer |e verfasserin |4 aut | |
| 700 | 1 | |a Wallis, Christopher J D |e verfasserin |4 aut | |
| 700 | 1 | |a Klaassen, Zachary |e verfasserin |4 aut | |
| 700 | 1 | |a Park, Henry S |e verfasserin |4 aut | |
| 700 | 1 | |a Goldberg, Sarah B |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Cancer |d 1948 |g 127(2021), 5 vom: 01. März, Seite 709-719 |w (DE-627)NLM000028649 |x 1097-0142 |7 nnns |
| 773 | 1 | 8 | |g volume:127 |g year:2021 |g number:5 |g day:01 |g month:03 |g pages:709-719 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1002/cncr.33269 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 127 |j 2021 |e 5 |b 01 |c 03 |h 709-719 | ||