Immune checkpoint inhibitors for first-line treatment of advanced non-small-cell lung cancer: A systematic review and network meta-analysis

doi:10.1111/1759-7714.14148

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Title:	Immune checkpoint inhibitors for first-line treatment of advanced non-small-cell lung cancer: A systematic review and network meta-analysis
Authors:	Peng, Tzu-Rong Lin, Hung-Hong Tsai, Fang-Pei Wu, Ta-Wei
Contributors:	Taipei Tzu Chi Hosp, Buddhist Tzu Chi Med Fdn, Dept Pharm Chia Nan Univ Pharm & Sci, Dept Pharm Taipei Med Univ, Coll Pharm, Sch Pharm
Keywords:	immune checkpoint inhibitors non-small cell lung cancer overall survival progression-free survival
Date:	2021
Issue Date:	2023-11-11 11:46:41 (UTC+8)
Publisher:	WILEY
Abstract:	Objective Currently, several immune checkpoint inhibitors (ICIs) treatment for advanced non-small-cell lung cancer (NSCLC) have been investigated; their overall efficacy and safety remain unclear. Methods We searched electronic databases such as PubMed, EMBASE, and the Cochrane library. The randomized controlled trials (RCTs) that compared ICIs with or without chemotherapy to chemotherapy in advanced NSCLC. We collected and compaired thier parameters, including overall survival (OS), progression-free survival (PFS), objective response rate (ORR), and treatment-related adverse events (TRAEs) of grade >= 3. Results A total of 15 RCTs involving 8869 patients with NSCLC were included. Pembrolizumab plus platinum-based chemotherapy had higher OS and PFS than platinum-based chemotherapy (hazard ratio [HR] 0.55, 95% CI 0.46-0.67; HR 0.54, 95% CI 0.41-0.70, respectively). Pembrolizumab plus platinum-based chemotherapy had higher ranked ORR than platinum-based chemotherapy (odds ratio [OR] 2.92, 95% CI 1.99-4.22). In terms of OS, atezolizumab, pembrolizumab plus platinum-based chemotherapy, and nivolumab plus ipilimumab ranked as the best treatments for patients with programmed death-ligand 1 (PD-L1) expression levels of >= 50%, 1-49%, and <1%, respectively. In terms of PFS, pembrolizumab plus platinum-based chemotherapy ranked as the best treatment for patients with any PD-L1 expression levels. However, ipilimumab plus platinum-based chemotherapy, nivolumab plus platinum-based chemotherapy, and atezolizumab plus platinum-based chemotherapy have higher TRAEs of grade >= 3 than platinum-based chemotherapy. Conclusions Pembrolizumab plus platinum-based chemotherapy prevailed in rank in OS, PFS, and ORR benefit. The TRAEs of pembrolizumab plus platinum-based chemotherapy were more than ICI monotherapy and chemotherapy.
Relation:	THORAC CANCER, v.12, n.21, pp.2873-2885
Appears in Collections:	[Dept. of Pharmacy] Periodical Articles

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