Safety and efficacy of PD-1/PD-L1 inhibitors in treatment naïve and chemotherapy refractory patients with Non-small cell lung cancer: a systematic review and meta-analysis

2.50
Hdl Handle:
http://hdl.handle.net/10757/622522
Title:
Safety and efficacy of PD-1/PD-L1 inhibitors in treatment naïve and chemotherapy refractory patients with Non-small cell lung cancer: a systematic review and meta-analysis
Authors:
Khunger, Monica; Jain, Prantesh; Rakshit, Sagar; Pasupuleti, Vinay; Hernandez, Adrian V. ( 0000-0002-9999-4003 ) ; Stevenson, James; Pennell, Nathan A.; Velcheti, Vamsidhar
Citation:
Safety and efficacy of PD-1/PD-L1 inhibitors in treatment naïve and chemotherapy refractory patients with Non-small cell lung cancer: a systematic review and meta-analysis 2018 Clinical Lung Cancer
Publisher:
Elsevier B.V.
Journal:
Clinical Lung Cancer
Issue Date:
Jan-2018
URI:
http://hdl.handle.net/10757/622522
DOI:
10.1016/j.cllc.2018.01.002
Additional Links:
http://linkinghub.elsevier.com/retrieve/pii/S1525730418300020
Abstract:
Introduction PD-1/PD-L1 inhibitors show significant clinical activity in non-small cell lung carcinoma (NSCLC). However, there is relative lack of data on comparative efficacy of these drugs in front-line setting versus chemotherapy-treated patients. We compared the efficacy and toxicity of these drugs in these two distinct groups of patients. Methods Electronic databases (PubMed-Medline, EMBASE, Scopus) and major conference proceedings were systematically searched for all phase I-III clinical trials in NSCLC using PD-1/PD-L1 inhibitors. Objective response rate (ORR) and progression free survival (PFS) data were collected and combined using DerSimonian and Laird random effects model meta-analysis. The I2 statistic was used to assess heterogeneity. Results Seventeen distinct trials (8 with treatment naïve patients [n = 937]; 14 with chemotherapy-treated patients [n = 3620]; 5 with separate treatment naïve and previously treated arms) were included. Treatment naïve patients had a statistically significant higher objective response rate (ORR 30.2% (95% CI 22.70-38.2) than previously chemotherapy treated patients (ORR 20.1% (95%CI 17.5-22.9; p=0.02). No significant differences in PFS were observed between the two groups. Treatment naive patients had statistically significant higher rates of all grade pneumonitis as compared to previously treated patients (4.9%, 95%CI 3.4-6.7 vs 3.0%, 95% CI 2.0-4.1, p=0.04); however, no significant differences in any other immune related adverse events were observed. Conclusions PD-1/PD-L1 inhibitor therapy for advanced NSCLC has a significantly higher objective response rate (ORR) and a higher rate of immune mediated pneumonitis when used in front-line setting as compared to chemotherapy treated patients.
Type:
info:eu-repo/semantics/article
Rights:
info:eu-repo/semantics/restrictedAccess
Language:
eng
Description:
El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado.
Keywords:
Non-small cell lung cancer; Meta-analysis; Immunotherapy; PD-1/PD-L1 inhibitors
ISSN:
15257304

Full metadata record

DC FieldValue Language
dc.contributor.authorKhunger, Monicaes
dc.contributor.authorJain, Pranteshes
dc.contributor.authorRakshit, Sagares
dc.contributor.authorPasupuleti, Vinayes
dc.contributor.authorHernandez, Adrian V.es
dc.contributor.authorStevenson, Jameses
dc.contributor.authorPennell, Nathan A.es
dc.contributor.authorVelcheti, Vamsidhares
dc.date.accessioned2018-01-16T13:33:18Z-
dc.date.available2018-01-16T13:33:18Z-
dc.date.issued2018-01-
dc.identifier.citationSafety and efficacy of PD-1/PD-L1 inhibitors in treatment naïve and chemotherapy refractory patients with Non-small cell lung cancer: a systematic review and meta-analysis 2018 Clinical Lung Canceres
dc.identifier.issn15257304-
dc.identifier.doi10.1016/j.cllc.2018.01.002-
dc.identifier.urihttp://hdl.handle.net/10757/622522-
dc.descriptionEl texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado.es_PE
dc.description.abstractIntroduction PD-1/PD-L1 inhibitors show significant clinical activity in non-small cell lung carcinoma (NSCLC). However, there is relative lack of data on comparative efficacy of these drugs in front-line setting versus chemotherapy-treated patients. We compared the efficacy and toxicity of these drugs in these two distinct groups of patients. Methods Electronic databases (PubMed-Medline, EMBASE, Scopus) and major conference proceedings were systematically searched for all phase I-III clinical trials in NSCLC using PD-1/PD-L1 inhibitors. Objective response rate (ORR) and progression free survival (PFS) data were collected and combined using DerSimonian and Laird random effects model meta-analysis. The I2 statistic was used to assess heterogeneity. Results Seventeen distinct trials (8 with treatment naïve patients [n = 937]; 14 with chemotherapy-treated patients [n = 3620]; 5 with separate treatment naïve and previously treated arms) were included. Treatment naïve patients had a statistically significant higher objective response rate (ORR 30.2% (95% CI 22.70-38.2) than previously chemotherapy treated patients (ORR 20.1% (95%CI 17.5-22.9; p=0.02). No significant differences in PFS were observed between the two groups. Treatment naive patients had statistically significant higher rates of all grade pneumonitis as compared to previously treated patients (4.9%, 95%CI 3.4-6.7 vs 3.0%, 95% CI 2.0-4.1, p=0.04); however, no significant differences in any other immune related adverse events were observed. Conclusions PD-1/PD-L1 inhibitor therapy for advanced NSCLC has a significantly higher objective response rate (ORR) and a higher rate of immune mediated pneumonitis when used in front-line setting as compared to chemotherapy treated patients.es
dc.formatapplication/pdfes
dc.language.isoenges
dc.publisherElsevier B.V.es
dc.relation.urlhttp://linkinghub.elsevier.com/retrieve/pii/S1525730418300020es
dc.rightsinfo:eu-repo/semantics/restrictedAccesses
dc.subjectNon-small cell lung canceres
dc.subjectMeta-analysises
dc.subjectImmunotherapyes
dc.subjectPD-1/PD-L1 inhibitorses
dc.titleSafety and efficacy of PD-1/PD-L1 inhibitors in treatment naïve and chemotherapy refractory patients with Non-small cell lung cancer: a systematic review and meta-analysises
dc.typeinfo:eu-repo/semantics/articlees
dc.identifier.journalClinical Lung Canceres
dc.description.peerreviewRevisión por pareses_PE
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