Efficacy and safety of first-line PD-1/PD-L1 inhibitor combinations for extensive-stage small-cell lung cancer: a Bayesian network meta-analysis
Objectives: Several randomized controlled trials (RCTs) indicated that first-line programmed cell death protein-1/death-ligand 1 inhibitors plus chemotherapy (PD-1/PD-L1 + chemo) led to survival benefits in extensive-stage small-cell lung cancer (ES-SCLC) compared with platinum-based chemotherapy. T...
| 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/10.1177/17588359231189430 |
| _version_ | 1797650138593755136 |
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| author | Huijuan Li Hedong Han Chuling Li Ranpu Wu Zhaofeng Wang Yimin Wang Ping Zhan Tangfeng Lv Fang Zhang Yong Song Hongbing Liu |
| author_facet | Huijuan Li Hedong Han Chuling Li Ranpu Wu Zhaofeng Wang Yimin Wang Ping Zhan Tangfeng Lv Fang Zhang Yong Song Hongbing Liu |
| author_sort | Huijuan Li |
| collection | DOAJ |
| description | Objectives: Several randomized controlled trials (RCTs) indicated that first-line programmed cell death protein-1/death-ligand 1 inhibitors plus chemotherapy (PD-1/PD-L1 + chemo) led to survival benefits in extensive-stage small-cell lung cancer (ES-SCLC) compared with platinum-based chemotherapy. This study aims to identify the optimal PD-1/PD-L1 + chemo combination strategy. Methods: We included RCTs comparing PD-1/ PD-L1 + chemo versus chemo alone in ES-SCLC. Overall survival (OS), progression-free survival (PFS), objective response rate (ORR), and grade ⩾3 treatment-related adverse events were considered. Odds ratios (ORs), hazard ratios (HRs), and their 95% confidence intervals (CIs) were extracted. Results: Six RCTs with 2600 patients were analyzed in this Bayesian network meta-analysis. Results showed that adding PD-1/PD-L1 inhibitors to chemotherapy led to significant benefits in OS (HR = 0.72, 95% CI: 0.66–0.79), PFS (HR = 0.69, 95% CI: 0.63–0.75), and ORR (OR = 1.32, 95% CI: 1.12–1.56), and no differences in toxicity were found (OR = 1.09, 95% CI: 0.92–1.30). Serplulimab plus chemotherapy was found to provide the best OS (HR = 0.63, 95% CI: 0.49–0.82), the best PFS (HR = 0.47, 95% CI: 0.38–0.59), and the best ORR (OR = 1.7, 95% CI: 1.15–2.53). Moreover, although there were no difference between PD-L1 + chemo and PD-1 + chemo regarding OS (HR = 0.99, 95% CI: 0.91–1.08) and ORR (OR = 1.27, 95% CI: 0.91–1.78), PD-1 + chemo showed a significant benefit in PFS (HR = 0.82, 95% CI: 0.68–0.98) compared with PD-L1 + chemo. Conclusions: Serplulimab plus chemotherapy seems to be superior first-line immunotherapy combination for patients with ES-SCLC. PD-1 + chemo seems to outperform PD-L1 + chemo in PFS. |
| first_indexed | 2024-03-11T15:56:59Z |
| format | Article |
| id | doaj.art-799b28fd028742db90e402bfff83e094 |
| institution | Directory Open Access Journal |
| issn | 1758-8359 |
| language | English |
| last_indexed | 2024-03-11T15:56:59Z |
| publishDate | 2023-10-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Therapeutic Advances in Medical Oncology |
| spelling | doaj.art-799b28fd028742db90e402bfff83e0942023-10-25T10:03:43ZengSAGE PublishingTherapeutic Advances in Medical Oncology1758-83592023-10-011510.1177/17588359231189430Efficacy and safety of first-line PD-1/PD-L1 inhibitor combinations for extensive-stage small-cell lung cancer: a Bayesian network meta-analysisHuijuan LiHedong HanChuling LiRanpu WuZhaofeng WangYimin WangPing ZhanTangfeng LvFang ZhangYong SongHongbing LiuObjectives: Several randomized controlled trials (RCTs) indicated that first-line programmed cell death protein-1/death-ligand 1 inhibitors plus chemotherapy (PD-1/PD-L1 + chemo) led to survival benefits in extensive-stage small-cell lung cancer (ES-SCLC) compared with platinum-based chemotherapy. This study aims to identify the optimal PD-1/PD-L1 + chemo combination strategy. Methods: We included RCTs comparing PD-1/ PD-L1 + chemo versus chemo alone in ES-SCLC. Overall survival (OS), progression-free survival (PFS), objective response rate (ORR), and grade ⩾3 treatment-related adverse events were considered. Odds ratios (ORs), hazard ratios (HRs), and their 95% confidence intervals (CIs) were extracted. Results: Six RCTs with 2600 patients were analyzed in this Bayesian network meta-analysis. Results showed that adding PD-1/PD-L1 inhibitors to chemotherapy led to significant benefits in OS (HR = 0.72, 95% CI: 0.66–0.79), PFS (HR = 0.69, 95% CI: 0.63–0.75), and ORR (OR = 1.32, 95% CI: 1.12–1.56), and no differences in toxicity were found (OR = 1.09, 95% CI: 0.92–1.30). Serplulimab plus chemotherapy was found to provide the best OS (HR = 0.63, 95% CI: 0.49–0.82), the best PFS (HR = 0.47, 95% CI: 0.38–0.59), and the best ORR (OR = 1.7, 95% CI: 1.15–2.53). Moreover, although there were no difference between PD-L1 + chemo and PD-1 + chemo regarding OS (HR = 0.99, 95% CI: 0.91–1.08) and ORR (OR = 1.27, 95% CI: 0.91–1.78), PD-1 + chemo showed a significant benefit in PFS (HR = 0.82, 95% CI: 0.68–0.98) compared with PD-L1 + chemo. Conclusions: Serplulimab plus chemotherapy seems to be superior first-line immunotherapy combination for patients with ES-SCLC. PD-1 + chemo seems to outperform PD-L1 + chemo in PFS.https://doi.org/10.1177/17588359231189430 |
| spellingShingle | Huijuan Li Hedong Han Chuling Li Ranpu Wu Zhaofeng Wang Yimin Wang Ping Zhan Tangfeng Lv Fang Zhang Yong Song Hongbing Liu Efficacy and safety of first-line PD-1/PD-L1 inhibitor combinations for extensive-stage small-cell lung cancer: a Bayesian network meta-analysis Therapeutic Advances in Medical Oncology |
| title | Efficacy and safety of first-line PD-1/PD-L1 inhibitor combinations for extensive-stage small-cell lung cancer: a Bayesian network meta-analysis |
| title_full | Efficacy and safety of first-line PD-1/PD-L1 inhibitor combinations for extensive-stage small-cell lung cancer: a Bayesian network meta-analysis |
| title_fullStr | Efficacy and safety of first-line PD-1/PD-L1 inhibitor combinations for extensive-stage small-cell lung cancer: a Bayesian network meta-analysis |
| title_full_unstemmed | Efficacy and safety of first-line PD-1/PD-L1 inhibitor combinations for extensive-stage small-cell lung cancer: a Bayesian network meta-analysis |
| title_short | Efficacy and safety of first-line PD-1/PD-L1 inhibitor combinations for extensive-stage small-cell lung cancer: a Bayesian network meta-analysis |
| title_sort | efficacy and safety of first line pd 1 pd l1 inhibitor combinations for extensive stage small cell lung cancer a bayesian network meta analysis |
| url | https://doi.org/10.1177/17588359231189430 |
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