Immune checkpoint inhibitors and chemotherapy in first-line NSCLC: a meta-analysis

被引:37
作者
Petrelli, Fausto [1 ]
Ferrara, Roberto [2 ]
Signorelli, Diego [2 ]
Ghidini, Antonio [3 ]
Proto, Claudia [2 ]
Roudi, Raheleh [4 ]
Sabet, Mehrdad N. [5 ]
Facelli, Sara [6 ]
Garassino, Marina C. [2 ]
Luciani, Andrea [1 ]
Roviello, Giandomenico [7 ]
机构
[1] ASST Bergamo Ovest, Med Oncol Unit, I-24047 Treviglio, BG, Italy
[2] Fdn IRCCS Ist Nazl Tumori, Dept Med Oncol, I-20133 Milan, Italy
[3] Casa Cura Igea, Med Oncol Unit, I-20126 Milan, Italy
[4] Univ Texas Hlth San Antonio, Dept Cell Syst & Anat, San Antonio, TX USA
[5] Minist Hlth & Med Educ, Canc Epidemiol Res & Treatment Ctr, Tehran, Iran
[6] Univ Florence, Sch Human Hlth Sci, Largo Brambilla 3, I-50134 Florence, Italy
[7] Univ Florence, Dept Hlth Sci, Sect Clin Pharmacol & Oncol, Florence, Italy
关键词
chemotherapy; combinations; first-line; immune checkpoint inhibitors; meta-analysis; non-small-cell lung cancer; PD-1; PD-L1; randomized trials; survival; CELL LUNG-CANCER; CARBOPLATIN; COMBINATION; PACLITAXEL; IPILIMUMAB; PEMBROLIZUMAB; ATEZOLIZUMAB; EFFICACY; ONCOLOGY; THERAPY;
D O I
10.2217/imt-2020-0224
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Lay abstract We provide a meta-analysis of randomized controlled trials in first-line studies where immune checkpoint inhibitors were added to chemotherapy (CT) and were compared with CT alone. Nine articles were included for qualitative and quantitative synthesis. A meta-analysis of the nine randomized trials indicated a significant benefit in terms of overall survival (OS; hazard ratio: 0.75 [95% CI: 0.66-0.85]; p < 0.01). Only programmed death ligand-1 positive-high cancers were observed to receive a significant OS benefit. In this meta-analysis, there is moderate evidence that the addition of immune checkpoint inhibitors to CT may improve OS as compared with CT alone. This study is a meta-analysis of randomized controlled trials involving first-line studies in which immune checkpoint inhibitors were added to chemotherapy and were compared with chemotherapy alone. The primary end point was overall survival (OS). The analyses used random-effects models and the Grading of Recommendations Assessment, Development, and Evaluation system to rate the quality of the evidence. Nine articles were included for qualitative and quantitative synthesis. A meta-analysis of the nine randomized trials showed a significant benefit in terms of OS (hazard ratio: 0.75 [95% CI: 0.66-0.85]; p < 0.01). Only programmed death ligand-1 positive-high cancers derive a significant OS benefit. In this meta-analysis, there is moderate evidence that the addition of immune checkpoint inhibitors to chemotherapy may improve both OS compared with chemotherapy alone.
引用
收藏
页码:621 / 632
页数:12
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