Addition of Immune Checkpoint Inhibitors to Chemotherapy vs Chemotherapy Alone as First-Line Treatment in Extensive-Stage Small-Cell Lung Carcinoma: A Systematic Review and Meta-Analysis

被引:17
作者
Arriola, Edurne [1 ]
Gonzalez-Cao, Maria [2 ]
Domine, Manuel [3 ]
De Castro, Javier [4 ]
Cobo, Manuel [5 ]
Bernabe, Reyes [6 ]
Navarro, Alejandro [7 ,8 ]
Sullivan, Ivana [9 ]
Manuel Trigo, Jose [10 ]
Mosquera, Joaquin [11 ]
Crama, Leonardo [12 ]
Isla, Dolores [13 ]
机构
[1] Hosp Univ Mar CIBERONC, Med Oncol Dept, Passeig Maritim 25-29, Barcelona 08003, Spain
[2] Hosp Dexeus, Med Oncol Dept IOR, Barcelona, Spain
[3] Fdn Jimenez Diaz, Med Oncol Dept, Madrid, Spain
[4] Hosp Univ La Paz, Med Oncol Dept, Madrid, Spain
[5] Reg & Virgen de la Victoria Univ Hosp, Interctr Med Oncol Clin Management Unit, IBIMA, Malaga, Spain
[6] Hosp Virgen del Rocio, Med Oncol Dept, Seville, Spain
[7] Vall dHebron Univ Hosp, Med Oncol Dept, Barcelona, Spain
[8] Vall dHebron Inst Oncol VHIO, Barcelona, Spain
[9] Hosp Santa Creu & Sant Pau, Med Oncol Dept, Barcelona, Spain
[10] Hosp Virgen de la Victoria, Med Oncol Dept, Malaga, Spain
[11] Hosp Univ A Coruna, Med Oncol Dept, La Coruna, Spain
[12] Med Dept Roche, Madrid, Spain
[13] Hosp Univ Lozano Blesa, Med Oncol Dept, Zaragoza, Spain
关键词
Anti-PD-1/PD-L1; antibodies; Chemotherapy; Immunotherapy; Meta-analysis; Small cell lung carcinoma; PLUS PLATINUM-ETOPOSIDE; CANCER; CARBOPLATIN; SURVIVAL; SAFETY; ATEZOLIZUMAB; IPILIMUMAB;
D O I
10.1007/s40487-021-00182-0
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Introduction: The addition of immune checkpoint inhibitors (ICIs) to conventional chemotherapy (CT) as first-line treatment improves survival in extensive-stage small-cell lung cancer (ES-SCLC). The aim of this meta-analysis was to determine the relative efficacy of first-line ICIs compared with CT in patients with ES-SCLC. Methods: Two independent reviewers extracted relevant data according to PRISMA guidelines and assessed the risk of bias using the Cochrane Collaboration's risk-of-bias tool. Meta-analysis was conducted using random-effects models to calculate an average effect size for overall survival (OS), progression-free survival (PFS), and safety outcomes in the overall populations and clinically relevant subgroups. Results: A literature search of PubMed and Embase was performed. Six randomized controlled clinical trials (IMpower133, CHECK-MATE-451, CASPIAN, KEYNOTE-604, and phase II and III ipilimumab plus CT trials) with a total of 3757 patients were included. Compared with CT alone, ICIs plus CT showed a favourable effect on OS (hazard ratio [HR] 0.85; 95% confidence intervals [CI] 0.79-0.96) and PFS (HR 0.78; 95% CI 0.72-0.83) but a non-significant age (< 65 years/>= 65 years), sex (men/women), and ECOG performance status (0/1). Analysis by specific ICI revealed significant improvements in OS only for atezolizumab + CT (HR 1.36; 95% CI 1.09-1.69) and durvalumab + CT (HR 1.35; 95% CI 1.12-1.62) compared with CT alone. Conclusion: Combining anti-programmed cell death ligand 1 antibodies with platinum/etoposide is a superior therapeutic approach compared to CT alone for the first-line treatment of patients with ES-SCLC. [GRAPHICS] .
引用
收藏
页码:167 / 184
页数:18
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