Checkpoint inhibitors plus chemotherapy for first-line treatment of advanced non-small cell lung cancer: a systematic review and meta-analysis of randomized controlled trials
We conducted a meta-analysis to evaluate the efficacy and safety of upfront add-on immunotherapy for advanced non-small cell lung cancers (NSCLC). We performed a literature search on first-line chemotherapy ± immunotherapy in NSCLC. We utilized Revman version 5.3 to calculate the estimated pooled ha...
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Published in | Future science OA Vol. 5; no. 9; p. FSO421 |
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Main Authors | , , , |
Format | Journal Article |
Language | English |
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England
Future Science Ltd
01.10.2019
Taylor & Francis Group |
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Abstract | We conducted a meta-analysis to evaluate the efficacy and safety of upfront add-on immunotherapy for advanced non-small cell lung cancers (NSCLC).
We performed a literature search on first-line chemotherapy ± immunotherapy in NSCLC. We utilized Revman version 5.3 to calculate the estimated pooled hazard ratio for overall survival (OS) and progression-free survival (PFS) and pooled risk ratio for objective response rate (ORR), all-grade and high-grade adverse events with 95% CI.
We analyzed 4322 patients. The pooled hazard ratios for OS, PFS and ORR were 0.74 (95% CI: 0.62–0.88; p = 0.0007), 0.62 (95% CI: 0.57–0.68; p = 0.00001) and 1.51 (95% CI: 1.3–1.74; p = 0.00001), respectively. The pooled risk ratios for all-grade and high-grade adverse events were 1.01 (95% CI: 0.99–1.03; p = 0.27) and 1.17 (95% CI: 1.07–1.28; p = 0.0006), respectively.
Add-on immunotherapy significantly improves PFS, OS and ORR for the first-line treatment of advanced NSCLC with a reasonable safety profile.
Lung cancer is the most frequent cancer and is the leading cause of cancer mortality worldwide – more than half of the patients presented at late-stage disease, which is associated with limited survival. To treat cancers, we use immune checkpoint inhibitors that release the brakes on the immune system; thus, the immune cells can kill cancer cells better. Multiple clinical trials have tested the role of immune checkpoint inhibitors combined with chemotherapy for lung cancer treatment. Based on these clinical trials, we conducted a systematic review that showed improvement in outcomes with combined chemotherapy and immunotherapy with acceptable adverse events. |
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AbstractList | Lung cancer is the most frequent cancer and is the leading cause of cancer mortality worldwide – more than half of the patients presented at late-stage disease, which is associated with limited survival. To treat cancers, we use immune checkpoint inhibitors that release the brakes on the immune system; thus, the immune cells can kill cancer cells better. Multiple clinical trials have tested the role of immune checkpoint inhibitors combined with chemotherapy for lung cancer treatment. Based on these clinical trials, we conducted a systematic review that showed improvement in outcomes with combined chemotherapy and immunotherapy with acceptable adverse events. We conducted a meta-analysis to evaluate the efficacy and safety of upfront add-on immunotherapy for advanced non-small cell lung cancers (NSCLC). We performed a literature search on first-line chemotherapy ± immunotherapy in NSCLC. We utilized Revman version 5.3 to calculate the estimated pooled hazard ratio for overall survival (OS) and progression-free survival (PFS) and pooled risk ratio for objective response rate (ORR), all-grade and high-grade adverse events with 95% CI. We analyzed 4322 patients. The pooled hazard ratios for OS, PFS and ORR were 0.74 (95% CI: 0.62–0.88; p = 0.0007), 0.62 (95% CI: 0.57–0.68; p = 0.00001) and 1.51 (95% CI: 1.3–1.74; p = 0.00001), respectively. The pooled risk ratios for all-grade and high-grade adverse events were 1.01 (95% CI: 0.99–1.03; p = 0.27) and 1.17 (95% CI: 1.07–1.28; p = 0.0006), respectively. Add-on immunotherapy significantly improves PFS, OS and ORR for the first-line treatment of advanced NSCLC with a reasonable safety profile. Lung cancer is the most frequent cancer and is the leading cause of cancer mortality worldwide – more than half of the patients presented at late-stage disease, which is associated with limited survival. To treat cancers, we use immune checkpoint inhibitors that release the brakes on the immune system; thus, the immune cells can kill cancer cells better. Multiple clinical trials have tested the role of immune checkpoint inhibitors combined with chemotherapy for lung cancer treatment. Based on these clinical trials, we conducted a systematic review that showed improvement in outcomes with combined chemotherapy and immunotherapy with acceptable adverse events. BACKGROUNDWe conducted a meta-analysis to evaluate the efficacy and safety of upfront add-on immunotherapy for advanced non-small cell lung cancers (NSCLC). METHODSWe performed a literature search on first-line chemotherapy ± immunotherapy in NSCLC. We utilized Revman version 5.3 to calculate the estimated pooled hazard ratio for overall survival (OS) and progression-free survival (PFS) and pooled risk ratio for objective response rate (ORR), all-grade and high-grade adverse events with 95% CI. RESULTSWe analyzed 4322 patients. The pooled hazard ratios for OS, PFS and ORR were 0.74 (95% CI: 0.62-0.88; p = 0.0007), 0.62 (95% CI: 0.57-0.68; p = 0.00001) and 1.51 (95% CI: 1.3-1.74; p = 0.00001), respectively. The pooled risk ratios for all-grade and high-grade adverse events were 1.01 (95% CI: 0.99-1.03; p = 0.27) and 1.17 (95% CI: 1.07-1.28; p = 0.0006), respectively. CONCLUSIONAdd-on immunotherapy significantly improves PFS, OS and ORR for the first-line treatment of advanced NSCLC with a reasonable safety profile. We conducted a meta-analysis to evaluate the efficacy and safety of upfront add-on immunotherapy for advanced non-small cell lung cancers (NSCLC). We performed a literature search on first-line chemotherapy ± immunotherapy in NSCLC. We utilized Revman version 5.3 to calculate the estimated pooled hazard ratio for overall survival (OS) and progression-free survival (PFS) and pooled risk ratio for objective response rate (ORR), all-grade and high-grade adverse events with 95% CI. We analyzed 4322 patients. The pooled hazard ratios for OS, PFS and ORR were 0.74 (95% CI: 0.62-0.88; p = 0.0007), 0.62 (95% CI: 0.57-0.68; p = 0.00001) and 1.51 (95% CI: 1.3-1.74; p = 0.00001), respectively. The pooled risk ratios for all-grade and high-grade adverse events were 1.01 (95% CI: 0.99-1.03; p = 0.27) and 1.17 (95% CI: 1.07-1.28; p = 0.0006), respectively. Add-on immunotherapy significantly improves PFS, OS and ORR for the first-line treatment of advanced NSCLC with a reasonable safety profile. Background: We conducted a meta-analysis to evaluate the efficacy and safety of upfront add-on immunotherapy for advanced non-small cell lung cancers (NSCLC). Methods: We performed a literature search on first-line chemotherapy ± immunotherapy in NSCLC. We utilized Revman version 5.3 to calculate the estimated pooled hazard ratio for overall survival (OS) and progression-free survival (PFS) and pooled risk ratio for objective response rate (ORR), all-grade and high-grade adverse events with 95% CI. Results: We analyzed 4322 patients. The pooled hazard ratios for OS, PFS and ORR were 0.74 (95% CI: 0.62–0.88; p = 0.0007), 0.62 (95% CI: 0.57–0.68; p = 0.00001) and 1.51 (95% CI: 1.3–1.74; p = 0.00001), respectively. The pooled risk ratios for all-grade and high-grade adverse events were 1.01 (95% CI: 0.99–1.03; p = 0.27) and 1.17 (95% CI: 1.07–1.28; p = 0.0006), respectively. Conclusion: Add-on immunotherapy significantly improves PFS, OS and ORR for the first-line treatment of advanced NSCLC with a reasonable safety profile. |
Author | Thein, Wai Lin Guevara, Elizabeth Thein, Kyaw Zin Tun, Aung Myint |
AuthorAffiliation | 2Department of Hematology & Oncology, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA 1Department of Medicine, Division of Hematology & Oncology, The Brooklyn Hospital Center, Brooklyn, NY 11201, USA 3University of Medicine 1, Yangon, Myanmar |
AuthorAffiliation_xml | – name: 3University of Medicine 1, Yangon, Myanmar – name: 1Department of Medicine, Division of Hematology & Oncology, The Brooklyn Hospital Center, Brooklyn, NY 11201, USA – name: 2Department of Hematology & Oncology, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA |
Author_xml | – sequence: 1 givenname: Aung Myint surname: Tun fullname: Tun, Aung Myint organization: Department of Medicine, Division of Hematology & Oncology, The Brooklyn Hospital Center, Brooklyn, NY 11201, USA – sequence: 2 givenname: Kyaw Zin surname: Thein fullname: Thein, Kyaw Zin organization: Department of Hematology & Oncology, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA – sequence: 3 givenname: Wai Lin surname: Thein fullname: Thein, Wai Lin organization: University of Medicine 1, Yangon, Myanmar – sequence: 4 givenname: Elizabeth surname: Guevara fullname: Guevara, Elizabeth organization: Department of Medicine, Division of Hematology & Oncology, The Brooklyn Hospital Center, Brooklyn, NY 11201, USA |
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Cites_doi | 10.1002/9780470712184.ch8 10.1111/1759-7714.12971 10.1136/bmj.327.7414.557 10.1200/JCO.2018.36.18_suppl.LBA9000 10.1016/S0140-6736(16)32517-X 10.1200/JCO.2011.38.4032 10.1016/S1470-2045(19)30167-6 10.3389/fonc.2019.00264 10.3322/caac.21551 10.1016/S1470-2045(16)30498-3 10.3322/caac.21492 10.1056/NEJMoa1801005 10.1056/NEJMoa1606774 10.1200/JCO.2018.36.15_suppl.9002 10.1002/ijc.31252 10.1038/cdd.2013.67 10.1056/NEJMoa1507643 10.1016/j.jtho.2018.08.262 10.1016/S0140-6736(15)01281-7 10.1200/JCO.2018.36.15_suppl.9001 10.1200/JCO.2016.71.7629 10.1056/NEJMoa1504627 10.4161/onci.27025 10.21037/jtd.2018.11.72 10.1056/NEJMoa1810865 10.1056/NEJMoa1801946 10.1056/NEJMoa1716948 |
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Keywords | advanced non-small-cell lung cancer first-line therapy objective response rate progression-free survival immune-related adverse events overall survival randomized controlled trials chemotherapy checkpoint inhibitors systematic review and meta-analysis |
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Snippet | We conducted a meta-analysis to evaluate the efficacy and safety of upfront add-on immunotherapy for advanced non-small cell lung cancers (NSCLC).
We performed... BACKGROUNDWe conducted a meta-analysis to evaluate the efficacy and safety of upfront add-on immunotherapy for advanced non-small cell lung cancers (NSCLC).... Lung cancer is the most frequent cancer and is the leading cause of cancer mortality worldwide – more than half of the patients presented at late-stage... Background: We conducted a meta-analysis to evaluate the efficacy and safety of upfront add-on immunotherapy for advanced non-small cell lung cancers (NSCLC).... |
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SubjectTerms | advanced non-small-cell lung cancer checkpoint inhibitors chemotherapy first-line therapy immune-related adverse events objective response rate overall survival progression-free survival randomized controlled trials Systematic Review systematic review and meta-analysis |
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Title | Checkpoint inhibitors plus chemotherapy for first-line treatment of advanced non-small cell lung cancer: a systematic review and meta-analysis of randomized controlled trials |
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