Clinical efficacy and safety of anti-PD-1/PD-L1 treatments in non-small cell lung cancer (NSCLC)

Aims: The present study was performed to investigate the efficacy and safety of anti-programmed death-1 (PD-1)/programmed death-ligand-1 (PD-L1) treatments in non-small cell lung cancer (NSCLC).Methods: The potential articles were searched from Pubmed and Embase. The end points included overall survival (OS), progression-free survival (PFS), objective response rate (ORR) and adverse events. p<.05 or I-2 >= 50% meant obvious heterogeneity, and the random-effects model was adopted for pooled analysis, otherwise, the fixed-effects model was used. Subgroup analysis was performed based on the treatment line. Potential publication bias was tested with Begg's funnel plot.Results: Eight eligible articles were included. OS rate of NSCLC patients was prolonged by anti-PD-1/PD-L1 treatments (HR = 0.685, 95%CI = 0.632-0.742), as well as PFS (HR = 0.821, 95%CI = 0.721-0.936). Meanwhile, anti-PD-1/PD-L1 treatments could greatly enhance the ORR (RR = 1.646, 95%CI = 1.382-1.961), with fewer adverse events (RR = 0.800, 95%CI = 0.688-0.931). Subgroup analysis indicated that anti-PD-1/PD-L1 treatments as second-line treatment could significantly improve the survival of patients without adverse events. The overall results were robust, without significant publication bias (p=.532).Conclusion: Anti-PD-1/PD-L1 treatments show better clinical efficacy and higher safety than chemotherapy in NSCLC.