Comparative efficacy and safety of novel immuno-chemotherapy for extensive-stage small-cell lung cancer: a network meta-analysis of randomized controlled trial
Background: Recently, several new first-line immune checkpoint inhibitors (ICIs) plus chemotherapy have been approved for patients with extensive-stage small-cell lung cancer (ES-SCLC). However, direct comparisons between first-line treatments are lacking. Therefore, we indirectly compared the effic...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2023-10-01
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| Series: | Therapeutic Advances in Medical Oncology |
| Online Access: | https://doi.org/10.1177/17588359231206147 |
| _version_ | 1797659980055183360 |
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| author | Youwen Zhu Kun Liu Hong Zhu Hui Cao Yangying Zhou |
| author_facet | Youwen Zhu Kun Liu Hong Zhu Hui Cao Yangying Zhou |
| author_sort | Youwen Zhu |
| collection | DOAJ |
| description | Background: Recently, several new first-line immune checkpoint inhibitors (ICIs) plus chemotherapy have been approved for patients with extensive-stage small-cell lung cancer (ES-SCLC). However, direct comparisons between first-line treatments are lacking. Therefore, we indirectly compared the efficacy and safety of specific treatment strategies to inform physicians’ and patients’ clinical decisions. Methods: The Pubmed, Cochrane, Embase, and Web of Science databases were searched from 1 January 2000 to 27 November 2022, for randomized clinical trials (RCTs) assessing first-line immuno-chemotherapies for ES-SCLC. A fixed-effect multivariable meta-regression model was established for frequentist network meta-analysis and hazard ratios (HRs) with 95% confidence intervals (95% CI) were computed to compare the effects of immuno-chemotherapies on patient overall survival (OS) and progression-free survival (PFS), while risk ratios with 95% CI were used for treatment- and immune-related adverse events (AEs). The p score values were then used to rank treatments based on their odds of being the best treatment option. The research protocol was registered with the PROSPERO (CRD42022383254). Results: Seven studies involving 3822 patients were eligible for analysis. Serplulimab plus chemotherapy had better OS outcomes compared to chemotherapy (HR = 0.63; 95% CI: 0.49–0.82) and ipilimumab plus chemotherapy (HR = 0.67; 95% CI: 0.50–0.90). It additionally exhibited better PFS outcomes compared to chemotherapy (HR = 0.48; 95% CI: 0.39–0.60), adebrelimab (HR = 0.72; 95% CI: 0.53–0.97), atezolizumab (HR = 0.62; 0.46–0.85), durvalumab (HR = 0.60; 95% CI: 0.45–0.80), durvalumab and tremelimumab (HR = 0.57; 95% CI: 0.43–0.76), ipilimumab (HR = 0.57; 95% CI: 0.44–0.73), and pembrolizumab (HR = 0.64; 95% CI: 0.48–0.86) plus chemotherapy. Serplulimab plus chemotherapy was linked to the greatest odds of effectively reducing the odds of death ( p score = 0.87) and progression ( p score = 0.99) while exhibiting a good safety profile. Conclusion: Serplulimab plus chemotherapy exhibited the best survival outcomes with manageable AEs. Thus, serplulimab plus chemotherapy may represent the optimal best first-line treatment option for ES-SCLC patients. |
| first_indexed | 2024-03-11T18:23:39Z |
| format | Article |
| id | doaj.art-717c19b3b424469cad6891409b25d080 |
| institution | Directory Open Access Journal |
| issn | 1758-8359 |
| language | English |
| last_indexed | 2024-03-11T18:23:39Z |
| publishDate | 2023-10-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Therapeutic Advances in Medical Oncology |
| spelling | doaj.art-717c19b3b424469cad6891409b25d0802023-10-14T18:34:21ZengSAGE PublishingTherapeutic Advances in Medical Oncology1758-83592023-10-011510.1177/17588359231206147Comparative efficacy and safety of novel immuno-chemotherapy for extensive-stage small-cell lung cancer: a network meta-analysis of randomized controlled trialYouwen ZhuKun LiuHong ZhuHui CaoYangying ZhouBackground: Recently, several new first-line immune checkpoint inhibitors (ICIs) plus chemotherapy have been approved for patients with extensive-stage small-cell lung cancer (ES-SCLC). However, direct comparisons between first-line treatments are lacking. Therefore, we indirectly compared the efficacy and safety of specific treatment strategies to inform physicians’ and patients’ clinical decisions. Methods: The Pubmed, Cochrane, Embase, and Web of Science databases were searched from 1 January 2000 to 27 November 2022, for randomized clinical trials (RCTs) assessing first-line immuno-chemotherapies for ES-SCLC. A fixed-effect multivariable meta-regression model was established for frequentist network meta-analysis and hazard ratios (HRs) with 95% confidence intervals (95% CI) were computed to compare the effects of immuno-chemotherapies on patient overall survival (OS) and progression-free survival (PFS), while risk ratios with 95% CI were used for treatment- and immune-related adverse events (AEs). The p score values were then used to rank treatments based on their odds of being the best treatment option. The research protocol was registered with the PROSPERO (CRD42022383254). Results: Seven studies involving 3822 patients were eligible for analysis. Serplulimab plus chemotherapy had better OS outcomes compared to chemotherapy (HR = 0.63; 95% CI: 0.49–0.82) and ipilimumab plus chemotherapy (HR = 0.67; 95% CI: 0.50–0.90). It additionally exhibited better PFS outcomes compared to chemotherapy (HR = 0.48; 95% CI: 0.39–0.60), adebrelimab (HR = 0.72; 95% CI: 0.53–0.97), atezolizumab (HR = 0.62; 0.46–0.85), durvalumab (HR = 0.60; 95% CI: 0.45–0.80), durvalumab and tremelimumab (HR = 0.57; 95% CI: 0.43–0.76), ipilimumab (HR = 0.57; 95% CI: 0.44–0.73), and pembrolizumab (HR = 0.64; 95% CI: 0.48–0.86) plus chemotherapy. Serplulimab plus chemotherapy was linked to the greatest odds of effectively reducing the odds of death ( p score = 0.87) and progression ( p score = 0.99) while exhibiting a good safety profile. Conclusion: Serplulimab plus chemotherapy exhibited the best survival outcomes with manageable AEs. Thus, serplulimab plus chemotherapy may represent the optimal best first-line treatment option for ES-SCLC patients.https://doi.org/10.1177/17588359231206147 |
| spellingShingle | Youwen Zhu Kun Liu Hong Zhu Hui Cao Yangying Zhou Comparative efficacy and safety of novel immuno-chemotherapy for extensive-stage small-cell lung cancer: a network meta-analysis of randomized controlled trial Therapeutic Advances in Medical Oncology |
| title | Comparative efficacy and safety of novel immuno-chemotherapy for extensive-stage small-cell lung cancer: a network meta-analysis of randomized controlled trial |
| title_full | Comparative efficacy and safety of novel immuno-chemotherapy for extensive-stage small-cell lung cancer: a network meta-analysis of randomized controlled trial |
| title_fullStr | Comparative efficacy and safety of novel immuno-chemotherapy for extensive-stage small-cell lung cancer: a network meta-analysis of randomized controlled trial |
| title_full_unstemmed | Comparative efficacy and safety of novel immuno-chemotherapy for extensive-stage small-cell lung cancer: a network meta-analysis of randomized controlled trial |
| title_short | Comparative efficacy and safety of novel immuno-chemotherapy for extensive-stage small-cell lung cancer: a network meta-analysis of randomized controlled trial |
| title_sort | comparative efficacy and safety of novel immuno chemotherapy for extensive stage small cell lung cancer a network meta analysis of randomized controlled trial |
| url | https://doi.org/10.1177/17588359231206147 |
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