Efficacy and safety of programmed death 1 inhibitors in patients with advanced non-small cell lung cancer: a meta-analysis

• Main Authors: Liu Y, Zhou S, Du Y, Sun L, Jiang H, Zhang B, Sun G, Wang R
• Format: Article
• Language: English
• Published: Dove Medical Press 2019-05-01
• Series: Cancer Management and Research
• Subjects: programmed death 1; lung cancer; efficacy; safety
• Online Access: https://www.dovepress.com/efficacy-and-safety-of-programmed-death-1-inhibitors-in-patients-with--peer-reviewed-article-CMAR

Yi Liu,1,* Sijing Zhou,2,* Yongsheng Du,3,* Li Sun,1 Huihui Jiang,1 Binbin Zhang,1 Gengyun Sun,1 Ran Wang11Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, People’s Republic of China; 2Hefei Prevention and Treatment Center for Occupational Diseases, Hefei 230022, People’s Republic of China; 3Department of General Medicine, Hefei Second People’s Hospital, Hefei 230022, People’s Republic of China*These authors contributed equally to this workObjective: This study aims to perform systematic review and meta-analysis of all randomized controlled trials that compare the efficacy and safety of programmed death 1 (PD-1) inhibitors versus chemotherapy alone in previously untreated advanced non-small cell lung cancer (NSCLC).Materials and methods: Several databases, including Medline, Cochrane Library, Embase, and Web of Science, were searched. The main outcome measures included overall survival (OS), progression-free survival (PFS), objective response rate (ORR), and adverse events (AEs).Results: The results of meta-analysis are expressed as the hazard ratio (HR) or risk ratio (RR) with their corresponding 95% confidence intervals (CIs). The final analysis included six trials for 3,930 patients. PD-1 inhibitors led to a statistically superior survival benefit over chemotherapy in patients with advanced NSCLC. OS was longer in patients who received PD-1 inhibitors (HR =0.71, 95% CI =0.62–0.74, P=0.000). Furthermore, PD-1 inhibitors had significantly higher objective response rate than chemotherapy (RR =0.20，95% CI =0.17–0.23, P=0.000). Meta-analysis showed that the AEs of any grade with PD-1 inhibitors were lower than those with chemotherapy (RR =0.78; 95% CI =0.75–0.81, P=0.000).Conclusion: PD-1 inhibitors showed a clinically meaningful survival benefit and an improved safety profile in patients with previously treated NSCLC.Keywords: programmed death 1, lung cancer, efficacy, safety