Indirect comparison of sintilimab and other PD-L1 inhibitors for first-line treatment of non-squamous non-small-cell lung cancer

• Published in: Future oncology (London, England) Vol. 18; no. 15; pp. 1896 - 1905
• Main Authors: Zhang, Lei, Qian, Yijiao, Li, Jinnan, Cui, Chenwei, Chen, Lu, Qu, Shuli, Lu, Shun
• Format: Journal Article
• Language: English
• Published: England Future Medicine Ltd 01.05.2022
• Subjects: Antibodies, Monoclonal, Humanized; Antineoplastic Combined Chemotherapy Protocols - adverse effects; B7-H1 Antigen; Carcinoma, Non-Small-Cell Lung - pathology; Humans; Immune Checkpoint Inhibitors; indirect comparison; Lung Neoplasms - pathology; non-squamous non-small-cell lung cancer; PD-L1 inhibitors; platinum-based doublet chemotherapy; indirect comparison; PD-L1 inhibitors; platinum-based doublet chemotherapy; non-squamous non-small-cell lung cancer
• ISSN: 1479-6694; 1744-8301
• DOI: 10.2217/fon-2021-1336

To evaluate sintilimab compared with other PD-L1 inhibitors in combination with platinum-based doublet chemotherapy as the first-line treatment of non-squamous non-small-cell lung cancer. A frequentist meta-analysis was used to compare outcomes, including progression-free survival, overall survival, objective response rate, time to response and safety profile. The sintilimab combination arm had progression-free survival comparable to that of the pembrolizumab combination arm (hazard ratio [HR] = 1.00; 95% CI: 0.71, 1.41), the atezolizumab combination arm (HR: 0.81; 95% CI: 0.59, 1.10), the tislelizumab combination arm (HR: 0.75; 95% CI: 0.48, 1.16), the camrelizumab combination arm (HR: 0.80; 95% CI: 0.54, 1.20) and the nivolumab combination arm (HR: 0.72; 95% CI: 0.51, 1.02). Any grade or grade ≥3 adverse event was comparable between PD-L1 inhibitors. Sintilimab showed a comparable efficacy and safety profile when compared with other PD-L1 inhibitors combined with platinum-based doublet chemotherapy as the first-line treatment of locally advanced or metastatic non-squamous non-small-cell lung cancer. Lung cancer is the most diagnosed cancer and the leading cause of cancer-related mortality in China. Non-small-cell lung cancer (NSCLC) accounts for 85% of all lung cancers, of which non-squamous NSCLC (nsqNSCLC) is the most frequent histologically, comprising 70% of NSCLC. Six different PD-L1 inhibitors (sintilimab, pembrolizumab, camrelizumab, atezolizumab, tislelizumab and nivolumab) in combination with chemotherapy have been approved as the first-line treatment of advanced/metastatic nsqNSCLC patients in China. Since there is no direct evidence of comparable efficacy and safety due to a lack of head-to-head trials among the PD-L1 inhibitors, an indirect comparison was conducted to evaluate sintilimab compared with other PD-L1 inhibitors in combination with platinum-based doublet chemotherapy. The results showed that sintilimab combined with platinum-based doublet chemotherapy showed progression-free survival, overall survival, objective response rate, time to response and safety profile comparable to other PD-L1 inhibitors in combination with platinum-based doublet chemotherapy as the first-line treatment of locally advanced or metastatic nsqNSCLC patients.