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
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Hernandez, Adrian V.
Pennell, Nathan A.
Fecha de publicación2018-01
MetadatosMostrar el registro completo del ítem
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 Cancer
JournalClinical Lung Cancer
ResumenIntroduction 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.
DescripciónEl texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado.