Anti-PD-1/PD-L1 Antibody Therapy for Pretreated Advanced or Metastatic Nonsmall Cell Lung Carcinomas and the Correlation between PD-L1 Expression and Treatment Effectiveness: An Update Meta-Analysis of Randomized Clinical Trials.

Purpose. This meta-analysis systematically evaluated the efficacy and safety of anti-PD-1/PD-L1 antibodies for pretreated advanced or metastatic nonsmall cell lung cancer (NSCLC) and investigated the correlation between PD-L1 expression levels and effectiveness of anti-PD-1/PD-L1 antibody. Methods....

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Published in:BioMed Research International Vol. 2018; pp. 1 - 10
Main Authors: Zhao, Qiuling, Xie, Ruixiang, Lin, Shen, You, Xiang, Weng, Xiuhua
Format: meta analysis research systematic review tables/charts Journal Article
Published: Wiley-Blackwell 9/24/2018
Online Access:View this record in EBSCOhost
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      dt: 9/24/2018
      vid: 2018
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        131931704
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        10.1155/2018/3820956
        131931704
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        atl: Anti-PD-1/PD-L1 Antibody Therapy for Pretreated Advanced or Metastatic Nonsmall Cell Lung Carcinomas and the Correlation between PD-L1 Expression and Treatment Effectiveness: An Update Meta-Analysis of Randomized Clinical Trials.
      aug:
        au:
          Zhao, Qiuling
          Xie, Ruixiang
          Lin, Shen
          You, Xiang
          Weng, Xiuhua
        affil: Department of Pharmacy, Fujian Provincial Cancer Hospital, Fuzhou 350000, Fujian Province, China
      sug:
        subj:
          Carcinoma, Non-Small-Cell Lung Drug Therapy
          Antibodies, Monoclonal Therapeutic Use
          Neoplasm Metastasis
          Neoplasm Staging
          Gene Expression
          Human
          Systematic Review
          Meta Analysis
          Randomized Controlled Trials
          Treatment Outcomes
          Docetaxel Therapeutic Use
          Odds Ratio
          Confidence Intervals
          Carcinoma, Non-Small-Cell Lung Prognosis
          Survival
          Adverse Drug Event
      ab: Purpose. This meta-analysis systematically evaluated the efficacy and safety of anti-PD-1/PD-L1 antibodies for pretreated advanced or metastatic nonsmall cell lung cancer (NSCLC) and investigated the correlation between PD-L1 expression levels and effectiveness of anti-PD-1/PD-L1 antibody. Methods. The methodology was based on the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) and the Cochrane Collaboration guidelines. Results. Our research included five randomized-controlled trials involving 3,025 patients. We compared anti-PD-1/PD-L1 antibodies (nivolumab, pembrolizumab, and atezolizumab) with docetaxel in pretreated patients with advanced or metastatic NSCLC. The pooled hazard ratio (HR) for overall survival (OS) and progression-free survival (PFS) was 0.69 (95%CI: 0.63-0.75, P<0.0001, and Ph=0.67) and 0.87 (95%CI: 0.81-0.94, P=0.0004, and Ph=0.11), respectively. Meanwhile, the pooled risk ratio (RR) for objective response rate (ORR) was 1.53 (95% CI: 1.16-2.01, P=0.003, and Ph=0.03) in all patients. Subgroup analyses showed that anti-PD-1/PD-L1 treatment significantly improved OS in patients with PD-L1 expression at any level, even in patients with PD-L1<1%. The RR for occurrence of grades 3 to 5 treatment-related adverse effects was 0.23 (95% CI: 0.15–0.36, and P<0.001). Conclusion. OS, PFS, and ORR were significantly more improved for patients treated with anti-PD-1/PD-L1 antibodies than for those treated with docetaxel. Anti-PD-1/PD-L1 therapy resulted in longer OS than docetaxel, regardless of PD-L1 expression; however, higher PD-L1 levels were likely to correlate with better outcome. Anti-PD-1/PD-L1 antibodies also had a better safety profile than docetaxel.
      pubtype: Academic Journal
      doctype:
        meta analysis
        research
        systematic review
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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