Programmed death-1 or programmed death ligand-1 inhibitors? A meta-analysis of differential efficacy as compared to chemotherapy in advanced non-small cell lung cancer.

Background: Programmed Death-1 (PD-1) and Programmed Death Ligand-1 (PDL-1) inhibitors have improved survival over chemotherapy in advanced Non- Small Cell Lung Cancer (NSCLC). However, it is unclear if there are class specific differences in the efficacy of Checkpoint Inhibitors (CPIs) in NSCLC, an...

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Publicado en:Journal of Oncology Pharmacy Practice Vol. 27; pp. 405 - 414
Autores principales: Bozcuk, Hakan, Artaç, Mehmet, Mutlu, Hasan, Sever, Özlem, Yıldırım, Mustafa
Formato: meta analysis research systematic review tables/charts Journal Article
Publicado: Sage Publications Inc. Mar2021
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Mar2021
      vid: 27
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      pub: Sage Publications Inc.
      place: Thousand Oaks, California
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        atl: Programmed death-1 or programmed death ligand-1 inhibitors? A meta-analysis of differential efficacy as compared to chemotherapy in advanced non-small cell lung cancer.
      aug:
        au:
          Bozcuk, Hakan
          Artaç, Mehmet
          Mutlu, Hasan
          Sever, Özlem
          Yıldırım, Mustafa
        affil: Department of Medical Oncology, Medical Park Hospital, Antalya, Turkey
      sug:
        subj:
          Carcinoma, Non-Small-Cell Lung Drug Therapy
          Programmed Cell Death Protein 1 Receptor Antagonists and Inhibitors
          Programmed Cell Death Ligand 1 Antagonists and Inhibitors
          Immune Checkpoint Inhibitors Therapeutic Use
          Carcinoma, Non-Small-Cell Lung Prognosis
          Treatment Outcomes
          Drug Efficacy
          Human
          Systematic Review
          Meta Analysis
          Survival Analysis
          PubMed
          Confidence Intervals
          Comparative Studies
          Antineoplastic Agents Pharmacodynamics
      ab: Background: Programmed Death-1 (PD-1) and Programmed Death Ligand-1 (PDL-1) inhibitors have improved survival over chemotherapy in advanced Non- Small Cell Lung Cancer (NSCLC). However, it is unclear if there are class specific differences in the efficacy of Checkpoint Inhibitors (CPIs) in NSCLC, and this paper is designed to answer these clinical questions. Methods: For this Meta-analysis, we searched PubMed, Science of Web, "Clinicaltrials.gov" and online sources for trials comparing PD-1 and PDL-1 CPIs in advanced NSCLC. The data for Hazard Ratio (HR) and their Confidence Intervals (CI) for Overall Survival (OS) was extracted. Results: A sum of 9739 patients from 16 trials were included in the efficacy evaluation. For the OS endpoint, both PD-1 inhibitors (HR = 0.76, 95%CI = 0.69–0.83, P < 0.001) and PDL-1 inhibitors (HR = 0.84, 95%CI = 0.74–0.95, P < 0.001) were superior to chemotherapy in treatment naïve (upfront) patients, the results were similar in treatment refractory patients (PD-1 inhibitors (HR = 0.67, 95%CI = 0.60–0.75, P < 0.001) and PDL-1 inhibitors (HR = 0.78, 95%CI = 0.69–0.88, P < 0.001) were superior to chemotherapy). There was no difference in the effect of PD-1 and PDL-1 classes of CPIs over chemotherapy in treatment naïve and treatment refractory settings (Q = 1.88, df = 1, P = 0.017, and, Q = 3.27, df = 1, P = 0.070, respectively). Conclusion: Efficacy of PD-1 and PDL-1 class of CPIs was not different, although differences among individual CPIs or their combinations cannot be excluded. We were also able to compute pooled efficacy data, as compared to chemotherapy alone, for trials where these groups of CPIs were utilized.
      pubtype: Academic Journal
      doctype:
        meta analysis
        research
        systematic review
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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