Immune checkpoint inhibitors as first-line therapy for non-small cell lung cancer: A systematic evaluation and meta-analysis
Recently, immune checkpoint inhibitors (ICIs) present promising application prospects in treating non-small cell lung cancer (NSCLC). This study aimed to investigate optimal treatment strategy by comparing the first-line treatment strategies with ICIs in NSCLC. We retrieved relevant studies on first...
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Format: | Article |
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Taylor & Francis Group
2023-01-01
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Series: | Human Vaccines & Immunotherapeutics |
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Online Access: | http://dx.doi.org/10.1080/21645515.2023.2169531 |
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author | Yu Lu Xiaoyan Zhang Jiyu Ning Manyan Zhang |
author_facet | Yu Lu Xiaoyan Zhang Jiyu Ning Manyan Zhang |
author_sort | Yu Lu |
collection | DOAJ |
description | Recently, immune checkpoint inhibitors (ICIs) present promising application prospects in treating non-small cell lung cancer (NSCLC). This study aimed to investigate optimal treatment strategy by comparing the first-line treatment strategies with ICIs in NSCLC. We retrieved relevant studies on first-line therapy of NSCLC with ICIs. Primary outcomes were overall survival (OS) and progression-free survival (PFS). Secondary outcomes were treatment-related serious adverse events (tr-SAEs) with grade 3 or higher and objective response rate (ORR). We also conducted a Bayesian network meta-analysis. We included 14 studies involving 7,823 patients and compared seven different interventions. In PD-L1 nonselective NSCLC, nivolumab+ipilimumab had good PFS and ORR, pembrolizumab significantly prolonged OS, and nivolumab had the fewest adverse events (AEs). For PD-L1-positive patients, nivolumab remarkably prolonged OS. For those with negative PD-L1, nivolumab+ipilimumab also showed an advantage. In addition, nivolumab+ipilimumab significantly prolonged the PFS in both PD-L1-negative and -positive patients. For patients with PD-L1 tumor proportion score (TPS) within 1–49%, atezolizumab+chemotherapy remarkably prolonged PFS and OS. For those with PD-L1 TPS ≥50%, pembrolizumab prolonged OS and atezolizumab+chemotherapy significantly prolonged PFS. Nivolumab combined with ipilimumab showed advantages in OS, PFS and ORR in most patients. Nivolumab+ipilimumab may be the optimal first-line therapy for NSCLC. |
first_indexed | 2024-03-11T21:39:55Z |
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issn | 2164-5515 2164-554X |
language | English |
last_indexed | 2024-03-11T21:39:55Z |
publishDate | 2023-01-01 |
publisher | Taylor & Francis Group |
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series | Human Vaccines & Immunotherapeutics |
spelling | doaj.art-951b923500c948a184ac837f52ea04442023-09-26T13:25:47ZengTaylor & Francis GroupHuman Vaccines & Immunotherapeutics2164-55152164-554X2023-01-0119110.1080/21645515.2023.21695312169531Immune checkpoint inhibitors as first-line therapy for non-small cell lung cancer: A systematic evaluation and meta-analysisYu Lu0Xiaoyan Zhang1Jiyu Ning2Manyan Zhang3University of South ChinaUniversity of South ChinaUniversity of South ChinaUniversity of South ChinaRecently, immune checkpoint inhibitors (ICIs) present promising application prospects in treating non-small cell lung cancer (NSCLC). This study aimed to investigate optimal treatment strategy by comparing the first-line treatment strategies with ICIs in NSCLC. We retrieved relevant studies on first-line therapy of NSCLC with ICIs. Primary outcomes were overall survival (OS) and progression-free survival (PFS). Secondary outcomes were treatment-related serious adverse events (tr-SAEs) with grade 3 or higher and objective response rate (ORR). We also conducted a Bayesian network meta-analysis. We included 14 studies involving 7,823 patients and compared seven different interventions. In PD-L1 nonselective NSCLC, nivolumab+ipilimumab had good PFS and ORR, pembrolizumab significantly prolonged OS, and nivolumab had the fewest adverse events (AEs). For PD-L1-positive patients, nivolumab remarkably prolonged OS. For those with negative PD-L1, nivolumab+ipilimumab also showed an advantage. In addition, nivolumab+ipilimumab significantly prolonged the PFS in both PD-L1-negative and -positive patients. For patients with PD-L1 tumor proportion score (TPS) within 1–49%, atezolizumab+chemotherapy remarkably prolonged PFS and OS. For those with PD-L1 TPS ≥50%, pembrolizumab prolonged OS and atezolizumab+chemotherapy significantly prolonged PFS. Nivolumab combined with ipilimumab showed advantages in OS, PFS and ORR in most patients. Nivolumab+ipilimumab may be the optimal first-line therapy for NSCLC.http://dx.doi.org/10.1080/21645515.2023.2169531nsclcimmune checkpoint inhibitorchemotherapyfirst-line therapynetwork meta-analysis |
spellingShingle | Yu Lu Xiaoyan Zhang Jiyu Ning Manyan Zhang Immune checkpoint inhibitors as first-line therapy for non-small cell lung cancer: A systematic evaluation and meta-analysis Human Vaccines & Immunotherapeutics nsclc immune checkpoint inhibitor chemotherapy first-line therapy network meta-analysis |
title | Immune checkpoint inhibitors as first-line therapy for non-small cell lung cancer: A systematic evaluation and meta-analysis |
title_full | Immune checkpoint inhibitors as first-line therapy for non-small cell lung cancer: A systematic evaluation and meta-analysis |
title_fullStr | Immune checkpoint inhibitors as first-line therapy for non-small cell lung cancer: A systematic evaluation and meta-analysis |
title_full_unstemmed | Immune checkpoint inhibitors as first-line therapy for non-small cell lung cancer: A systematic evaluation and meta-analysis |
title_short | Immune checkpoint inhibitors as first-line therapy for non-small cell lung cancer: A systematic evaluation and meta-analysis |
title_sort | immune checkpoint inhibitors as first line therapy for non small cell lung cancer a systematic evaluation and meta analysis |
topic | nsclc immune checkpoint inhibitor chemotherapy first-line therapy network meta-analysis |
url | http://dx.doi.org/10.1080/21645515.2023.2169531 |
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